Anesth Pain Med.  2016 Jul;11(3):260-263. 10.17085/apm.2016.11.3.260.

Anaphylactic shock caused by an intradermal skin test-negative antibiotic during general anesthesia: A case report

• Kim KN
• Kim DW
• Sin YH
• Oh SY

• KMID: 2344928
• DOI: http://doi.org/10.17085/apm.2016.11.3.260

Abstract

Anaphylaxis during the perioperative period is rare, but it still causes severe cardiovascular and respiratory collapse that can be fatal. In particular, when using antibiotics that have a high risk of hypersensitivity reactions, it is important to establish that intradermal skin tests are negative before using antibiotics. We report a case of anaphylactic shock occurring during general anesthesia after using an intradermal skin test-negative antibiotic. Regrettably, negative results of intradermal skin tests before using antibiotics do not completely eliminate the risk of anaphylaxis. Therefore, anesthesiologists should be prepared for anaphylaxis to occur at any point during the perioperative period.

Keyword

Anaphylaxis; Anti-bacterial agents; Intradermal tests

MeSH Terms

Anaphylaxis*
Anesthesia, General*
Anti-Bacterial Agents
Hypersensitivity
Intradermal Tests
Perioperative Period
Skin Tests
Skin*
Anti-Bacterial Agents

Figure

• 

  Fig. 1 Graphs of vital signs during surgery. At 25 minutes after the operation, pulse oxygen saturation dropped abruptly to 86% and blood pressure dropped to 60/30 mmHg with increased pulse rate of 120 beats/min. Epinephrine 0.5 mg was injected intravenously with hydration to treat the anaphylactic shock. As a result, blood pressure slowly increased to 100–120/50–70 mmHg, and pulse rate decreased to 80 beats/min.

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