{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T07:46:59Z","timestamp":1782200819076,"version":"3.54.5"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T00:00:00Z","timestamp":1774137600000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Allergy Immunology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Group A beta\u2010hemolytic Streptococcus (GABHS) infections have surged globally in the post\u2013SARS\u2010CoV\u20102 era, coinciding with an increase in the number of children referred for suspected delayed hypersensitivity to penicillin administered during acute infection. GABHS\u2010related rashes may resemble non\u2010immediate drug reactions, complicating diagnosis, and contributing to inappropriate penicillin allergy diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Medical charts from patients followed at Allergy Unit of Meyer Children's Hospital IRCCS, Florence, Italy and Pediatric Department of \u201cVittore Buzzi\u201d Children's Hospital, Milan, Italy, who underwent a penicillin drug provocation test (DPTs) between August 2015 and August 2025, were retrospectively reviewed. Only patients with documented, laboratory\u2010confirmed GABHS infections treated with penicillin were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seventy patients treated with penicillin for concomitant GABHS infections that developed rash during therapy were included. The median time to rash insurgence was after 7\u2009days of treatment (IQR\u2009=\u20094\u2009days). Maculopapular rash was the most frequent (43\/70, 61.4%) followed by urticarial rash in the remaining cases (27\/70, 38.6%). No systemic reactions were reported. DPTs were negative in 63\/70 (90%) patients, with only mild cutaneous reactions in the remaining cases, all manageable with antihistamines. All patients who experienced a positive DPT initially reported an urticarial rash as the reason for referral, whereas all patients with a history of maculopapular rash as the index reaction showed a negative DPT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>GABHS may be associated with a rash that mimics delayed penicillin allergy, which is excluded by negative DPTs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pai.70322","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T05:15:05Z","timestamp":1774242905000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Increase of post\u2013SARS\u2010CoV\u20102 rashes mimicking penicillin allergy in children with Group A beta\u2010hemolytic Streptococcus infection: An emerging and challenging issue"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5633-9025","authenticated-orcid":false,"given":"Francesco","family":"Catamer\u00f2","sequence":"first","affiliation":[{"name":"Department of Health Sciences University of Florence  Florence Italy"},{"name":"Allergy Unit Meyer Children's Hospital IRCCS  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Beretta","sequence":"additional","affiliation":[{"name":"Allergy Unit\u2010Department of Pediatrics Buzzi Children's Hospital  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5216-0423","authenticated-orcid":false,"given":"Giulia","family":"Liccioli","sequence":"additional","affiliation":[{"name":"Allergy Unit Meyer Children's Hospital IRCCS  Florence 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