Retrospective analysis shows nearly half of patients with EBV-related rash post-penicillin have lasting drug allergy, highlighting the need for allergy testing.
Patients with infectious mononucleosis are often treated with penicillins, frequently resulting in maculopapular rashes resembling delayed drug hypersensitivity reactions (DHR). To assess the risk of persistent allergy, we retrospectively identified adolescent and adult patients from a hospital record database, who developed an EBV-related rash after penicillin treatment and later underwent allergy testing. Of the 15 included patients, nearly half showed evidence of persistent drug allergy, with positive skin tests being more common in those with prolonged reactions. Some patients experienced recurrent DHR following re-exposure before testing. These findings emphasize the importance of allergy testing in patients with EBV-related DHR to prevent unnecessary antibiotic restrictions and avoid unintended re-exposures.
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Cao et al. (2025) studied this question.
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