Cefotaxim induced a near fatal anaphylactic shock in an infant

• Autores: Álvaro Moreno Ancillo, A.C. Gil Adrados
• Localización: Allergologia et immunopathologia: International journal for clinical and investigate allergology and clinical immunology, ISSN-e 1578-1267, ISSN 0301-0546, Vol. 40, Nº. 2, 2012, págs. 125-126
• Idioma: inglés
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• Resumen

  • To the Editor, Severe anaphylactic reactions are potentially life-threatening.1, 2 In the literature, foods, venom and drugs are the most commonly reported exogenous causative agents.3 Symptoms vary widely and can involve multiple organ systems, with skin, gastrointestinal, respiratory and cardiovascular symptoms.2 In the paediatric population, allergic disorders have reached epidemic proportions, and anaphylaxis is an increasingly common event. However, drug induced life-threatening anaphylactic shock is still very rare in infants under six months of age.4, 5, 6, 7 We report a 4-month-old girl who had a severe anaphylactic reaction within one minute after an intravenous administration of the third dose of cefotaxime (200 mg dissolved in 10ml of specific solvent) given for a bronchial infection. Drug was administered by intravenous �push� over two to four minutes, rather than by a more prolonged intravenous infusion of 30minutes. At the same time, she had just finished the intake of 180ml of cow's milk. It was her second admission at the hospital. She had tolerated intravenous cefotaxime two months before, in her first admission. Symptoms included facial flush with swelling of the lips, urticarial rash on her trunk which progressed to generalised urticaria, intense dyspnoea, shortness of breath, wheezing and cyanosis with severe hypotension and collapse. After adequate treatment with intense anti-shock therapy, which was high flow oxygen, intravenous crystalloid fluid 20mL/kg, intravenous hydrocortisone 25mg, and three doses of intramuscular adrenaline, these symptoms were considerably reduced within one hour; and completely resolved after six hours. The patient had no other medical history. Skin prick tests were...