Fluconazole


Fluconazole is a triazole antifungal agent used in the treatment of infections of the nails, skin, oral and vaginal mucosa; systemic candidiasis, cryptococcal meningitis and as prophylaxis for cryptococcal infections in HIV patients.
 
Incidence
Probably very low.
 
Clinical manifestations
Anaphylactic shock.
 
Rashes, maculopapular eruptions, fixed drug eruptions, angioedema, toxic epidermal necrolysis, Stevens-Johnson’s syndrome.
 
Diagnostic methods
Cutaneous testing
 
One case with positive skin-prick tests 1/10.
 
Mechanisms
Unknown.
 
Management
Cross-reactivity with other azole derivatives is likely.
 
Desensitization (orally): 0.2 mg to 400 mg in 15 days.

References

  1. Craig T.J, Peralta F, Boggavarapu J, "Desensitization for fluconazole hypersensitivity", J. Allergy. Clin. Immunol, 1996 ; 98 (4): 845-6
  2. Neuhaus G, Pavic N, Pletscher M, "Anaphylactic reaction after oral fluconazole", B.M.J, 1991 ; 302 (6788): 1341

As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.