Asthma Allergy Immunology

Asthma Allergy Immunology

Drug-Induced Enterocolitis Syndrome with Amoxicillin- Clavulanic Acid and Alternative Beta Lactam Antibiotic

Gokhan YORUSUN 1, Ahmet SELMANOGLU 1, Zeynep SENGUL EMEKSIZ 1, Emine DIBEK MISIRLIOGLU 2,

1 Department of Pediatric Allergy and Immunology, Ankara City Hospital, Ankara, Türkiye
2 Department of Pediatric Allergy and Immunology, Health Sciences University, Ankara City Hospital, Ankara, Türkiye

DOI: 10.21911/aai.2024.578
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Drug-induced enterocolitis syndrome (DIES) is a rare hypersensitivity reaction characterized by delayed gastrointestinal symptoms following ingestion of triggering medications. We report the case of a seven-year-old male presenting with symptoms consistent with DIES after receiving amoxicillin-clavulanic acid (AMX/CLV) for tonsillitis and soft tissue infection.

The patient experienced recurrent vomiting and lethargy 2-3 hours post-administration of AMX/CLV. Following supportive care and clarithromycin treatment, the symptoms resolved. Oral provocation testing with AMX/CLV resulted in severe abdominal pain, vomiting, and lethargy, confirming DIES. Patch testing with various beta-lactam antibiotics yielded negative results. Subsequent oral provocation with cefuroxime axetil showed no adverse reactions, suggesting an alternative.

This case highlights the importance of considering DIES as a differential diagnosis in patients presenting with delayed gastrointestinal symptoms following drug intake. Identifying alternative antibiotics is crucial for the management of such cases.

Keywords : Pediatric, drug-induced enterocolitis syndrome, amoxicillin/clavulanic acid, alternative antibiotic