Chronic Urticaria on Woman With Toxoplasmosis Post Spiramycin Treatment: A Rare Case

Authors

  • Astrid Amanda Wahyu Putri Faculty of Medicine, Brawijaya University, Malang, Indonesia
  • Muhammad Edel Dwiputra Prawira General Practitioner, Soepraoen Army Hospital, Malang, Indonesia
  • Harastha Qinthara Mathilda Pembangunan Nasional Veteran Jakarta University, Indonesia
  • Faradiani Rasyidi Dermatologist, BRI Medika Hospital, Malang, Indonesia

Keywords:

Chronic urticaria, toxoplasmosis, spiramycin, macrolide

Abstract

Spiramycin is a macrolide antibiotic with a bacteriostatic action and is used as a toxoplasmosis treatment since the FDA considers it safe and can be taken throughout early pregnancy. As the therapeutic use of spiramycin increases, reports of hypersensitivity responses, characterized as urticaria, are also on the rise. A 27-year-old woman presented to the hospital with chief complaints of recurrent rash with redness and severe itch on her entire body for one week. The rash appeared after the patient was diagnosed with toxoplasmosis and instructed to take spiramycin regularly. Two months ago, the patient experienced the same complaints. The patient was diagnosed with spiramycin-induced chronic urticaria and administered dexamethasone, diphenhydramine, and fexofenadine orally. Clinical improvement is evident after three days of treatment, as evidenced by a weekly decrease in the UAS-7 score. Urticaria is a hypersensitivity reaction that can be triggered by antibiotic consumption. A comprehensive diagnosis is needed to determine the etiology of urticaria, including the history of drug consumption. Treatment of urticaria includes education and the administration of antihistamines and corticosteroids. Chronic urticaria requires special treatment from a dermato-venerologist.  

Author Biographies

Astrid Amanda Wahyu Putri, Faculty of Medicine, Brawijaya University, Malang, Indonesia

Faculty of Medicine, Brawijaya University, Malang, Indonesia  

Muhammad Edel Dwiputra Prawira, General Practitioner, Soepraoen Army Hospital, Malang, Indonesia

General Practitioner, Soepraoen Army Hospital, Malang, Indonesia  

Harastha Qinthara Mathilda, Pembangunan Nasional Veteran Jakarta University, Indonesia

Pembangunan Nasional Veteran Jakarta University, Indonesia  

Faradiani Rasyidi, Dermatologist, BRI Medika Hospital, Malang, Indonesia

Dermatologist, BRI Medika Hospital, Malang, Indonesia  

References

Wertenteil S, Strunk A, Garg A. Prevalence estimates for chronic urticaria in the United States: A sex- and age-adjusted population analysis. J Am Acad Dermatol. 2019 Jul;81(1):152–6.

Chung WH, Chu CY, Huang YH, Wang WM, Yang CH, Tsai TF. Taiwanese Dermatological Association consensus for the definition, classification, diagnosis, and management of urticaria. Journal of the Formosan Medical Association. 2016 Nov;115(11):968–80.

Zuberbier T, Maurer M. Urticaria: Current opinions about etiology, diagnosis, and therapy. Acta Derm Venereol. 2007;87(3):196–205.

Zuberbier T, Abdul Latiff AH, Abuzakouk M, Aquilina S, Asero R, Baker D, et al. The international EAACI/GA2LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria. Allergy. 2022 Mar 20;77(3):734–66.

Bernstein JA, Lang DM, Khan DA, Craig T, Dreyfus D, Hsieh F, et al. The diagnosis and management of acute and chronic urticaria: 2014 update. Zuberbier T, Grattan CEH, Maurer M, editors. Journal of Allergy and Clinical Immunology. 2014 May 22;133(5):1270-1277.e66.

Kang MJ, Kim HS, Kim HO, Park YM. The Impact of Chronic Idiopathic Urticaria on Quality of Life in Korean Patients. Ann Dermatol. 2009;21(3):226.

Tan EK, Grattan CE. Drug-induced urticaria. Expert Opin Drug Saf. 2004 Sep 23;3(5):471–84.

Vacek V. Spiramycin. Cas Lek Cesk. 1994;133(2):56–60.

CDC A. Parasites-toxoplasmosis (Toxoplasma infection). Am J Trop Med Hyg. 2014;9(1):794–9.

Deganich M, Boudreaux C, Benmerzouga I. Toxoplasmosis Infection during Pregnancy. Trop Med Infect Dis. 2022 Dec 21;8(1):3.

Ünal D, Demir S, Gelincik A, Olgaç M, Coşkun R, Çolakoğlu B, et al. Diagnostic Value of Oral Challenge Testing in the Diagnosis of Macrolide Hypersensitivity. J Allergy Clin Immunol Pract. 2018 Mar;6(2):521–7.

JM L. A Case Report on Cetirizine Induced Urticaria. Clinical Dermatology Open Access Journal. 2018;3(2).

Tadros S, Bahal S, Nagendran V. Case Report: Resolution of chronic urticaria following treatment of odontogenic infection. F1000Res. 2019 Jun 6;7:1738.

Seitz CS, Bröcker EB, Trautmann A. Suspicion of macrolide allergy after treatment of infectious diseases including Helicobacter pylori: Results of allergological testing. Allergol Immunopathol (Madr). 2011 Jul;39(4):193–9.

Araujo L, Demoly P. Macrolides Allergy. Curr Pharm Des. 2008 Sep 1;14(27):2840–62.

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Published

2023-08-07

How to Cite

1.
Putri AAW, Prawira MED, Mathilda HQ, Rasyidi F. Chronic Urticaria on Woman With Toxoplasmosis Post Spiramycin Treatment: A Rare Case. J Pak Assoc Dermatol [Internet]. 2023Aug.7 [cited 2024Oct.5];33(3):1119-23. Available from: https://jpad.com.pk/index.php/jpad/article/view/2274

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Case Reports

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