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https://ahro.austin.org.au/austinjspui/handle/1/35519
Full metadata record
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Cox, Fionnuala | - |
dc.contributor.author | Holmes, Natasha E | - |
dc.contributor.author | Waldron, Jamie Lee | - |
dc.contributor.author | Trubiano, Jason | - |
dc.date | 2024 | - |
dc.date.accessioned | 2024-10-21T03:41:15Z | - |
dc.date.available | 2024-10-21T03:41:15Z | - |
dc.date.issued | 2024-11 | - |
dc.identifier.citation | The Journal of Allergy and Clinical Immunology. Global 2024-11; 3(4) | en_US |
dc.identifier.issn | 2772-8293 | - |
dc.identifier.uri | https://ahro.austin.org.au/austinjspui/handle/1/35519 | - |
dc.description.abstract | Penicillin-associated exanthems in the setting of infectious mononucleosis caused by Epstein-Barr virus (EBV) are often viewed as a transient event, not a true allergy. Recent evidence challenges this and suggests that a notable subset of patients retain penicillin hypersensitivity. We investigated the occurrence and predictors of persistent adulthood hypersensitivity in those with penicillin-associated rash occurring in the setting of EBV infection. Retrospective analysis of data of patients referred for penicillin allergy testing to an Australian tertiary-care hospital captured from 2015 to 2023 was carried out. Of 2066 patients, 23 (1%) had penicillin-associated rash during an historic EBV infection; 16 (70%) were female; and median (interquartile range) age was 18 (16-20) years at index reaction and 38 (33.5-57) years at allergy testing. Skin prick testing and delayed intradermal testing to a penicillin panel were performed, followed by oral provocation challenge in those testing negative. Persistent sensitization was shown in 6 (26%) of 23; 4 (67%) of 6 positive delayed intradermal testing; and 3 (50%) of 6 had positive oral challenge test. Notably, 5 (83%) of 6 had a severe maculopapular exanthem with facial swelling, including 2 (33%) of 6 with probable drug reaction with eosinophilia and systemic symptoms (aka DRESS) during the index reaction, compared to 0 of 17 in patients tolerating penicillin on reexposure. This study highlights the requirement of allergy testing in adult patients reporting a penicillin-associated severe maculopapular exanthem in the setting of EBV, even if it occurred during childhood or adolescence. | en_US |
dc.language.iso | eng | - |
dc.subject | DRESS | en_US |
dc.subject | EBV | en_US |
dc.subject | Maculopapular exanthema | en_US |
dc.subject | Penicillin allergy | en_US |
dc.subject | allergy testing | en_US |
dc.subject | delayed drug rash | en_US |
dc.title | Rash decisions: Unmasking a risk phenotype in adults with persistent delayed penicillin allergy sensitized during historic infection with Epstein-Barr virus. | en_US |
dc.type | Journal Article | en_US |
dc.identifier.journaltitle | The Journal of Allergy and Clinical Immunology. Global | en_US |
dc.identifier.affiliation | Infectious Diseases | en_US |
dc.identifier.affiliation | Department of Medicine, Division of Allergy and Immunology, Massachusetts General Hospital, and Harvard Medical School, Boston, Mass. | en_US |
dc.identifier.affiliation | Centre for Antibiotic Allergy and Research | en_US |
dc.identifier.doi | 10.1016/j.jacig.2024.100320 | en_US |
dc.type.content | Text | en_US |
dc.identifier.pubmedid | 39282619 | - |
dc.description.volume | 3 | - |
dc.description.issue | 4 | - |
dc.description.startpage | 100320 | - |
item.cerifentitytype | Publications | - |
item.languageiso639-1 | en | - |
item.grantfulltext | none | - |
item.openairetype | Journal Article | - |
item.fulltext | No Fulltext | - |
item.openairecristype | http://purl.org/coar/resource_type/c_18cf | - |
crisitem.author.dept | Infectious Diseases | - |
crisitem.author.dept | Data Analytics Research and Evaluation (DARE) Centre | - |
crisitem.author.dept | Infectious Diseases | - |
crisitem.author.dept | Medicine (University of Melbourne) | - |
crisitem.author.dept | Centre for Antibiotic Allergy and Research | - |
Appears in Collections: | Journal articles |
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