LÖFFLER'S SYNDROME FOLLOWING USE OF A VAGINAL CREAM

Abstract

A case is reported of a patient who had 3 successive episodes of illness consisting of fever, cough, generalized abdominal and muscular pains, nausea and anorexia, and transient pulmonary rales. Each bout of illness occurred 12-36 hrs. following the use of a vaginal cream, the chief constituents of which are allantoin and sulfonilamide. Chest X-ray revealed pulmonary infiltrations which cleared rapidly. There was leukocytosis with marked eosinophilia. All diagnostic studies, including stool examination for ova and parasites and a skin test for Trichinella, were negative. Upon the vaginal instillation of another dose of the cream as a provocative test, the exact clinical picture descr. above, including the leukocytosis and eosinophilia, reappeared within 6 hrs. This is considered to be a case of Loffler''s syndrome appearing as an allergic reaction to a sulfonamide-containing vaginal cream, the vaginal mucosa serving as the route of sensitization.