Selective Sensitization to Penicillin V with Tolerance to Other Betalactams

ISSN: 2212-2710 (Online)
ISSN: 1872-213X (Print)


Volume 8, 3 Issues, 2014


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Selective Sensitization to Penicillin V with Tolerance to Other Betalactams

Author(s): Leticia Sánchez-Morillas, Patricia Rojas-Pérez-Ezquerra, Rosario González-Mendiola, Prado Gómez- Tembleque and Julio Laguna-Martínez

Affiliation: Servicio de Alergia, Hospital Central de la Cruz Roja, Reina Victoria 22, 28003 Madrid, Spain.

Abstract

Background: Penicillin G and V have the same betalactam ring. Penicillin V (phenoxymethylpenicillin) results from the substitution of the phenyl acetic acid of benzylpenicillin by the phenoxy methyl side chain. Methods: Our patient was a 34-year-old man who experienced generalized urticaria after ingestion of Penicillin V. We performed skin prick tests and intradermal tests with a battery of betalactams including Penicillin V. We also determined specific IgE against penicillin V, penicillin G, amoxicillin, and ampicillin and performed a single-blind oral challenge with Penicillin V, amoxicillin, cefuroxime, and ceftazidime. Results: The results of skin prick and intradermal tests with the betalactams included were negative. Specific IgE with betalactams was < 0.10 IU/L. The result of a single-blind oral challenge with Penicillin V was positive: 40 minutes after receiving 125mg of Penicillin V, the patient presented generalized pruritus with hives on his back and chest. He tolerated oral administration of amoxicillin, cefuroxime, and ceftazidime. Conclusion: We report an exceptional case of sensitization to Penicillin V with negative results in the allergy workup. Diagnosis was based on a positive single-blind oral challenge result. The patient tolerated other betalactams. We provide a brief summary of the most relevant recent patents.

Keywords: Betalactams, cross-reactivity, hypersensitivity, intradermal tests, penicillin V, urticaria.

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Article Details

Volume: 8
Issue Number: 1
First Page: 74
Last Page: 76
Page Count: 3
DOI: 10.2174/1872213X08666140121155419
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