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Abstract
Fluconazole is a triazole-based first-generation antifungal agent and has excellent effects on candidiasis and cryptococcosis. Hyper-sensitivity has been reported as a side effect of fluconazole. A 76-year-old female patient used fluconazole for consolidation therapy for cryptococcal meningitis, but showed delayed hypersensitivity with skin rashes and itching sensation of the whole body. For desensitization, was attempted by administering 12-step, 1:1 fluconazole solutions were administered intravenously at sequentially increasing infusion rates. After successful quick desensitization to fluconazole, fluconazole was continuously used as a consolidation therapy for cryptococcal meningitis. We herein report a case of delayed hypersensitivity reaction to fluconazole in consolidation therpy with cryptococcal meningitis who successfully completed desensitization.
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Fig. 1.
Clinical features of the fluconazole-induced delayed type hypersensitivity. There was diffuse patch eruption involving the trunk (A) and extremities (B) with itching and blanching, which continued for several days.
Table 1.
The preparation of 1-bottle solution used in the rapid desensitization protocol
| Fluconazole (mg) | DW (mL) | Preparation protocol | Concentration (mg/mL) |
|---|---|---|---|
| 400 | 250 | 400 mg+DW 250 mL | 1.6 |
Table 2.
Desensitization protocol used in the current case of the fluconazole-induced delayed hypersensitivity
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