D Benjamin Lash1,2, J Jolliff3, A Munoz4, A Heidari4. 1. Western University of Health Sciences, Pomona, CA, USA. 2. VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA. 3. Department of Pharmacy, Kern Medical, Bakersfield, CA, USA. 4. Department of Medicine, Kern Medical, Bakersfield, CA, USA.
Abstract
WHAT IS KNOWN AND OBJECTIVE: Hypersensitivity to triazoles is a rare occurrence and cross-reactivity between agents is unknown. We present a successful voriconazole challenge in a patient allergic to fluconazole and itraconazole. CASE SUMMARY: A 41-year-old immunocompetent male with coccidioidomycosis developed fever, eosinophilia and maculopapular rash from fluconazole. Switching to itraconazole resulted in worsening of the rash and skin sloughing over 25% of his body. He was given an oral-graded challenge of voriconazole which he tolerated without incident. WHAT IS NEW AND CONCLUSION: This is the first report of a lack of cross-reactivity between itraconazole and voriconazole.
WHAT IS KNOWN AND OBJECTIVE:Hypersensitivity to triazoles is a rare occurrence and cross-reactivity between agents is unknown. We present a successful voriconazole challenge in a patient allergic to fluconazole and itraconazole. CASE SUMMARY: A 41-year-old immunocompetent male with coccidioidomycosis developed fever, eosinophilia and maculopapular rash from fluconazole. Switching to itraconazole resulted in worsening of the rash and skin sloughing over 25% of his body. He was given an oral-graded challenge of voriconazole which he tolerated without incident. WHAT IS NEW AND CONCLUSION: This is the first report of a lack of cross-reactivity between itraconazole and voriconazole.
Authors: Jeffrey D Jenks; Helmut Jf Salzer; Juergen Prattes; Robert Krause; Dieter Buchheidt; Martin Hoenigl Journal: Drug Des Devel Ther Date: 2018-04-30 Impact factor: 4.162