Fluconazole is a triazole-based first-generation antifungal agent and has excellent effects on candidiasis and cryptococcosis. Hypersensitivity has been reported as a side effect of fluconazole. A 76-year-old female patient used fluconazole for consolidation therapy for cryptococcal meningitis, but showed delayed hypersensitivity with skin rashes and itching sensation of the whole body. For desensitization, was attempted by administering 12-step, 1:1 fluconazole solutions were administered intravenously at sequentially increasing infusion rates. After successful quick desensitization to fluconazole, fluconazole was continuously used as a consolidation therapy for cryptococcal meningitis. We herein report a case of delayed hypersensitivity reaction to fluconazole in consolidation therpy with cryptococcal meningitis who successfully completed desensitization.
Aged ; Candidiasis ; Cryptococcosis ; Exanthema ; Female ; Fluconazole ; Humans ; Hypersensitivity ; Hypersensitivity, Delayed ; Meningitis, Cryptococcal ; Pruritus ; Sensation

Behcet's disease is a multisystemic disease, in which vascular involvement occurs in 7. 7-60% of patients. There are three forms of vascular involvement such as venous occlusion, arterial occlusion and arterial aneurysm. Venous lesions are more common than arterial lesions and the common sites of venous thrombosis are inferior vena cava, superior vena cava, and superficial or deep veins of extremities. Thrombosis of cerebral venous sinus is an infrequent complication of Behcet's disease and it seems to be rare that both deep vein thrombosis and cerebral venous sinus thrombosis occured at the same time. We experienced a case of Behcet's disease complicated with thromboses of left common femoral vein and right transverse sinus. A 29-year-old man presented with persistent dull nature headache, nausea, vomiting, blurred vision and left lower leg swelling. Duplex ultrasonography of lower extremity showed thrombus in the left common femoral vein. Magnetic resonance imaging of brain showed isodense signal intensity lesions in right transverse sinus on Tl weighted image. On magnetic resonance angiography, the right transverse, sigmoid sinus and right internal jugular vein were not visualized. The patient showed substantial improvement after treatment with steroid, cyclosporine A and anticoagulants.
Adult ; Aneurysm ; Anticoagulants ; Brain ; Colon, Sigmoid ; Cyclosporine ; Extremities ; Femoral Vein ; Headache ; Humans ; Jugular Veins ; Leg ; Lower Extremity ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Nausea ; Sinus Thrombosis, Intracranial* ; Thrombosis ; Ultrasonography ; Veins ; Vena Cava, Inferior ; Vena Cava, Superior ; Venous Thrombosis* ; Vomiting

BACKGROUND/AIMS: This study was to evaluate the clinical significance of infusion-related reaction (IRR) of rituximab in diffuse large B-cell lymphoma (DLBCL) patients who received R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) as a first-line chemotherapy. METHODS: The medical records of 326 patients diagnosed with DLBCL were re trospectively analyzed. Both doctor's progress records and nursing records were reviewed. IRR was graded according to the National Cancer Institute Common Terminology Criteria. RESULTS: IRR was not associated with overall survival (OS) or progression-free survival (PFS) of DLBCL patients as compared to those who did not have IRR (OS: median 78.0 months vs. 69.0 months, p = 0.700; PFS: median 65.4 months vs. 64.0 months, p = 0.901). IRR grade did not affect OS or PFS. B symptoms was independently associated with IRR (hazard ratio [HR], 1.850; 95% confidence interval [CI], 1.041 to 3.290; p = 0.036). Further, bone marrow involvement was independently associated with re-IRR (HR, 4.904; 95% CI, 0.767 to 3.118; p = 0.029). CONCLUSIONS Our study shows that IRR of rituximab is not associated with OS or PFS of DLBCL patients who received R-CHOP. Furthermore, our study suggests a need for more careful observation for IRR in patients with B symptoms or bone marrow involvement.