Maternal Allergy to Fluconazole-An Unusual Presentation: Case Report in a Breastfeeding Mother

Background: Allergy to fluconazole is uncommon and even more so in lactating women receiving treatment as part of treatment for neonatal oral thrush. Methods: We report a case of a rare and unexpected adverse reaction occurring after a single dose of fluconazole (Diflucan), administered to a mother of an exclusively breastfed neonate with oral thrush, as per guideline recommendations. Results: The woman developed multiple symptomatic manifestations highly suspicious of a hypersensitivity reaction after 8 h of taking a single 150 mg dose which were managed with antihistamines and cessation of medication. The baby's symptoms abated with treatment and the mother whose hypersensitivity symptoms abated with treatment continued to breastfeed. Conclusion: We recommend that in prescribing antifungals to women whose babies have neonatal oral thrush, clinicians must always bear in mind that a history of previous allergic reaction(s) could signal the possibility of an allergic reaction to the antifungal agent. Counselling should therefore include the potential for reactions and steps to take if these develop. With supportive treatment, appropriate therapies and cessation of the medication, these invariably resolve. Where these persist, offering topical antifungal options may minimize the risk of recurrence of the hypersensitivity.