Lendak Dajana, Mihajlović Dunja, Turkulov Vesna, Stefan Mikić Sandra, Tomiç Slavica
Klinika za infektivne bolesti Klinicki centar Vojvodine, Novi Sad.
Med Pregl. 2012 Mar-Apr;65(3-4):138-41. doi: 10.2298/mpns1204138l.
Rash can be one of the symptoms in acute infectious mononucleosis. According to the classical literature sources, drug-induced rash can be associated with synthetic penicillin and Epstein-Barr virus itself Nowadays, a lot of case reports point to the development of rash after the administration of other groups of antimicrobials. Clinical and laboratory signs and the administration of antimicrobials in acute Epstein-Barr virus infection have been correlaed with the development of rash.
This retrospective-prospective study (2007-2010) included 243 patients hospitalized for acute infectious mononucleosis at the Department for Infectious Diseases, Clinical Center of Vojvodina, of whom 51 had rash and 192 were without it. Epstein-Barr virus infection was confirmed by ELISA IgM EBV VCA in all patients.
Student's t-test did not show a significant difference between the age, gender, duration of symptoms, leucocytes count, absolute lymphocytes count, alanine aminotransferase, aspartate aminotransferase among patients with or without rash. Chi2 test did not show a significant difference among the patients treated by synthetic or pure penicillin, macrolids and 1st and 2nd generation cephalosporins. However, if we compare all these antimicrobials, there is a significant difference between them and 3rd generation cephalosporins. Only two patients developed rash without antimicrobials.
According to our results, rash developed independently of the clinical course of disease. Previous conclusion that synthetic penicillin produces rash seems to be not true, because there are many patients who were treated with them but did not develop rash. All antimicrobials can be associated with rash, but 3rd generation cephalosporins seem to produce rash less frequently than the others.
皮疹可能是急性传染性单核细胞增多症的症状之一。根据经典文献资料，药物性皮疹可能与合成青霉素及爱泼斯坦-巴尔病毒本身有关。如今，许多病例报告指出在使用其他类抗菌药物后也会出现皮疹。急性爱泼斯坦-巴尔病毒感染时的临床和实验室体征以及抗菌药物的使用与皮疹的发生相关。
这项回顾性-前瞻性研究（2007 - 2010年）纳入了伏伊伏丁那临床中心传染病科因急性传染性单核细胞增多症住院的243例患者，其中51例有皮疹，192例无皮疹。所有患者均通过酶联免疫吸附测定法（ELISA）检测爱泼斯坦-巴尔病毒IgM VCA确诊感染。
学生t检验显示，有皮疹和无皮疹患者在年龄、性别、症状持续时间、白细胞计数、绝对淋巴细胞计数、丙氨酸转氨酶、天冬氨酸转氨酶方面无显著差异。卡方检验显示，使用合成青霉素或纯青霉素、大环内酯类以及第一代和第二代头孢菌素治疗的患者之间无显著差异。然而，如果我们比较所有这些抗菌药物，它们与第三代头孢菌素之间存在显著差异。只有两名患者在未使用抗菌药物的情况下出现皮疹。
根据我们的结果，皮疹的发生与疾病的临床病程无关。先前关于合成青霉素会引起皮疹的结论似乎并不正确，因为有许多使用了它们但未出现皮疹的患者。所有抗菌药物都可能与皮疹有关，但第三代头孢菌素引起皮疹的频率似乎比其他药物低。
