Cefazolin
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Anaphylaxis in an infant: case report A 5-month-old girl developed anaphylaxis during treatment with cefazolin for prophylaxis against surgical infection. The girl, who had received amoxicillin 1 month previously for pyelonephritis, experienced acute pyelonephritis and underwent surgery for obstruction of ureteropelvic junction. Following successful surgery, she received IV cefazolin 250mg in 45 minutes. In a few seconds, she developed apnoea, bradycardia, hypotension, cyanosis and cardiovascular collapse. She was diagnosed with anaphylaxis to cefazolin. The girl immediately received epinephrine [adrenaline], diphenhydramine, oxygen, ranitidine, methylprednisolone and fluid expansion. Her respiratory capacity and vital signs started to become normal 30 minutes after intervention; her HR was 110 beats/min, her BP was 90/50mm Hg and respiratory rate was 36 breaths/min. Her supply of nasal oxygen was weaned slowly over the following 3 hours. She was followed up for 3 days; she received diphenhydramine and methylprednisolone for late reactions. She was discharged treated with diphenhydramine. Before discharge, the girl underwent penicillin- and amoxicillin-specific immunoglobulins, which were positive. Skin prick testing with cefazolin at different concentrations was undertaken. Cefazolin 2 mg/mL in normal saline was undertaken 1 month after the reaction; this was positive with a wheal of 10mm and a concentration of 2 mg/mL. Intradermal prick test with penicillin was also positive. Cefazolin hypersensitivity was confirmed. Tayman C, et al. Unexpected cefazolin anaphylaxis in a 5-month-old girl. Pediatric 801111667 Emergency Care 24: 344-345, No. 5, May 2008 - Turkey
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Reactions 21 Jun 2008 No. 1207
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