Beta-lactam (BL) antibiotics are the most frequent cause of drug hypersensitivity in children, inducing both immediate and non-immediate reactions. Here we report a case of a 4-year-old child with a disseminated maculopapular exanthema 7 days after the first dose of amoxicillin–clavulanate, referred to our paediatric allergy department. Skin prick tests were negative. Intradermal tests were performed and, after 10 hours, indurated wheals larger than 10×10 mm with progressive erythema and disseminated maculopapular eruption were developed, related to amoxicillin and amoxicillin–clavulanate. Systemic reactions to BL skin tests are rarely reported and the majority are immediate reactions. This case illustrates a rare example of a non-immediate systemic reaction to intradermal tests, underlying the importance of skin testing before drug provocation tests in cases of moderate to severe non-immediate reactions.

中文翻译：

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β-内酰胺皮内皮肤试验中的全身反应

β-内酰胺 (BL) 抗生素是儿童药物过敏的最常见原因，可引起立即反应和非立即反应。在此，我们报告一例 4 岁儿童在首次服用阿莫西林克拉维酸 7 天后出现播散性斑丘疹皮疹，转诊至我们的儿科过敏科。皮肤点刺试验呈阴性。进行皮内试验，10小时后，出现大于10×10毫米的硬性风团，伴有进行性红斑和播散性斑丘疹，与阿莫西林和阿莫西林克拉维酸有关。BL 皮肤测试的全身反应很少有报道，大多数是立即反应。该病例说明了皮内试验非立即全身反应的罕见例子，这表明在中度至重度非立即反应的情况下，在药物激发试验之前进行皮肤测试的重要性。