A diagnostic workup of perioperative anaphylaxis reveals a selective type 1 hypersensitivity to cefazolin
- Author:
Meera Thalayasingam
;
Lynette Pei-Chi Shek
- Publication Type:Case Reports
- Keywords:
Allergy;
anaphylaxis;
cefazolin;
cephalosporin;
perioperative anaphylaxis
- MeSH:
Anaphylaxis
- From:International e-Journal of Science, Medicine and Education
2015;9(2):37-39
- CountryMalaysia
- Language:English
-
Abstract:
Abstract: Anaphylaxis in the operating room although
infrequent can be potentially fatal.1
The diagnosis
of perioperative anaphylaxis is complex due to a
multitude of factors. Firstly, patients under anesthesia
cannot verbalize their complaints, the anesthetic
agents themselves can alter vital parameters (e.g.
heart rate and blood pressure) and cutaneous signs in
a completely draped patient may be missed.2
Secondly,
the differential diagnosis of intraoperative anaphylaxis
is wide. Conditions such as asthma exacerbation,
arrhythmia, hemorrhage, angioedema, mastocytosis,
acute myocardial infarction, drug overdose, pericardial
tamponade, pulmonary edema, pulmonary embolus,
sepsis, tension pneumothorax, vasovagal reaction, venous
air embolism, laryngospasm, blood transfusion reaction
and malignant hyperthermia need to be considered.3
Thirdly, the diagnostic workup is challenging due
to the multiple medications administered and other
exposures encountered such as latex and chlorhexidene.
However, through a timely allergy consultation and a
systematic approach, identification of the culprit agent
and safe alternatives can be established to prevent future
occurrences as illustrated in the case below.
- Full text:P020150903538894033309.pdf
