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Cross-reactivity between voriconazole, fluconazole and itraconazole
D Benjamin Lash1,2, J Jolliff3, A Munoz4
1Western University of Health Sciences, Pomona, CA, USA.
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.
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