EBV infection and aminopenicillin exanthema:
The use of aminopenicillins in young adults with an EBV infection has long been considered an almost mandatory cause of exanthema, with an initially reported incidence of over 80% [37]. However, current data report a much lower incidence of aminopenicillin-induced exanthema (10-30%) [3, 13]. Moreover, many patients tolerate aminopenicillins upon later re-exposure and skin tests show negative results. Some patients with EBV infection and DHR however retain their reactivity to aminopenicillins and may react to the drug (alone) again with rather severe reactions for many years [12, 38]. The reason for this distinct persistence of drug reactivity is unclear. The duration and extent of the initial reaction, the presence of facial swelling, and clinical severity of extracutaneous manifestations may indicate prolonged drug reactivity and should prompt the decision to perform a diagnostic workup [39].