What is known and objective: Hypersensitivity to triazoles is a rare occurrence and cross-reactivity between agents is unknown. We present a successful voriconazole challenge in a patient allergic to fluconazole and itraconazole.
Case summary: A 41-year-old immunocompetent male with coccidioidomycosis developed fever, eosinophilia and maculopapular rash from fluconazole. Switching to itraconazole resulted in worsening of the rash and skin sloughing over 25% of his body. He was given an oral-graded challenge of voriconazole which he tolerated without incident.
What is new and conclusion: This is the first report of a lack of cross-reactivity between itraconazole and voriconazole.
Keywords: allergy; fluconazole; itraconazole; voriconazole.
© 2016 John Wiley & Sons Ltd.