EBV infection and aminopenicillin exanthema:
The use of aminopenicillins in young adults with an EBV infection has
long been considered an almost mandatory cause of exanthema, with an
initially reported incidence of over 80% [37]. However, current
data report a much lower incidence of aminopenicillin-induced exanthema
(10-30%) [3, 13]. Moreover, many patients tolerate aminopenicillins
upon later re-exposure and skin tests show negative results. Some
patients with EBV infection and DHR however retain their reactivity to
aminopenicillins and may react to the drug (alone) again with rather
severe reactions for many years [12, 38]. The reason for this
distinct persistence of drug reactivity is unclear. The duration and
extent of the initial reaction, the presence of facial swelling, and
clinical severity of extracutaneous manifestations may indicate
prolonged drug reactivity and should prompt the decision to perform a
diagnostic workup [39].