Carpani Matteo, Smussi Davide, Esposito Andrea, Consoli Francesca, Berruti Alfredo, Alberti Andrea
Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST Spedali Civili, 25123 Brescia, Italy.
Viruses. 2025 Mar 4;17(3):368. doi: 10.3390/v17030368.
The concomitant use of antibiotics, especially beta lactams, during acute EBV infection is widely associated with an increased risk of skin manifestations; the actual pathophysiology and prevalence of this phenomenon are still debated.
We present the first reported case of atypical exanthema associated with amoxicillin intake in a patient with EBV-related nasopharyngeal carcinoma. We recorded a pattern in the plasma EBV-DNA load consisting of a significant increase at the onset of the rash with a sudden remission after its resolution. The patient recovered without sequelae.
DISCUSSION/CONCLUSIONS: The temporal relationship and the reported data on rash morphology, clinical findings and triggering factors support a possible correlation between the intake of beta-lactam antibiotics, particularly amoxicillin, and the onset of cutaneous manifestations in a patient with nasopharyngeal carcinoma. Such reactions can be a challenging differential diagnosis and may warrant increased provider consideration when choosing to prescribe beta lactams in patients affected by nasopharyngeal cancer.
在急性EBV感染期间同时使用抗生素，尤其是β-内酰胺类抗生素，与皮肤表现风险增加广泛相关；这种现象的实际病理生理学和患病率仍存在争议。
我们报告了首例与阿莫西林摄入相关的非典型皮疹病例，该患者患有EBV相关鼻咽癌。我们记录了血浆EBV-DNA载量的一种模式，即在皮疹发作时显著增加，皮疹消退后突然缓解。患者康复且无后遗症。
讨论/结论：时间关系以及关于皮疹形态、临床发现和触发因素的报告数据支持β-内酰胺类抗生素，特别是阿莫西林的摄入与鼻咽癌患者皮肤表现发作之间可能存在关联。此类反应可能是具有挑战性的鉴别诊断，在为鼻咽癌患者开β-内酰胺类药物时，可能需要医生更多地考虑。
