Ceftriaxone Induced fixed drug eruption in patient with common variable immunodeficiency

Adverse drug reactions are one of the most complex and difficult diagnostic problems in practice of allergists and clinical immunologists. This article presents a clinical case of a patient with inborn error of immunity, known as common variable immune deficiency with the debut of the disease in adulthood and the presence of numerous infectious, structural, and immune complications. The patient had an adverse drug reaction representive by fixed drug eruption to the vital antibiotic therapy with ceftriaxone. We provide detailed information about this type of drug allergy, structural features of cephalosporins and their cross-reactivity. In the diagnostic process, we ran phased drug allergy testing: patch tests and a dose provocative test, wich is considered as a gold standard for this type of diagnostics. According to the test results the diagnosis of fixed drug eruption to ceftriaxone and the absence of cross-reactivity to other cephalosporins in this patient was confirmed. The compiled individual recommendations made it possible to prohibit the use of only one drug (ceftriaxone), which is especially important for a patient with primary immunodeficiency.