Drug induced Urticaria
A female patient of twenty-five years of age developed fever for ten days, followed by vomiting and loose stools for three days
She was apparently normal ten days back.
She was treated at a local clinic three days back. She was prescribed following medications -Cefuroxime 250 mg, Azithromycin 250 mg, Paracetamol 250 mg, Oseltamivir 75 mg. Cefuroxime 250 mg BD given, and first dose of cefuroxime was taken at night and the rash occurred next morning.
She developed macular rashes over the face, neck and hands after the intake of the first of the drugs.
Clinical findings
Diagnosis was made as Drug induced Urticaria.
Cefuroxime, a second-generation cephalosporin, used to treat various bacterial infections, is known to cause this reaction.
Discussion
- Urticaria is a skin condition characterized by raised, itchy welts that can be triggered by various factors and by medications like cefuroxime.
- Cefuroxime-induced urticaria may also involve non-immunological mechanisms, such as direct histamine release or activation of other pathways leading to mast cell degranulation, contributing to the onset of urticaria symptoms.
- It also involves the formation of hapten-protein complexes, triggering an immunological response characterized by the release of inflammatory mediators such as histamine
Reference: A. Nakamura et al., 2009; J. F. Silveira et al., 2012.
