Cefazolin
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Anaphylaxis: case report An 18-year-old woman with a history of atrial septal defect developed anaphylaxis while receiving cefazolin. The woman was scheduled to undergo ankle surgery under general anaesthesia, and received cefazolin [dosage not stated] for endocarditis prophylaxis. Within minutes, she developed severe anaphylaxis with cardiovascular depression, generalised urticaria and angioedema. On presentation to an allergy department, she reported a history of surgical procedures with antibiotic prophylaxis, which had included cefazolin on several occasions; she had not previously experienced any adverse reactions. Further corrective heart surgery was scheduled for the future. Basophil activation test and cellular antigen stimulation test (CAST) with cefazolin 200 µg/mL showed increased CD63 expression and sulfidoleukotrien release, respectively. Intracutaneous tests were positive for cefazolin 2 mg/mL and cefotiam, and possibly positive to cefuroxime. Oral challenge with cefuroxime axetil led to urticaria after about 90 minutes, which spontaneously resolved within 12 hours; oral rechallenge with cefazolin was considered unethical. All tested penicillins, amoxicillin and some cephalosporins were well tolerated. Author comment: In this case, an immediate-type allergy to the first generation cephalosporin cefazolin was ascertained by skin tests, basophil activation test and CAST. Wieczorek D, et al. Anaphylactic reaction to cefazolin with good tolerance to penicillin, amoxicillin and single cephalosporins. Aktuelle Dermatologie 34: 22-25, 801117178 No. 1-2, 2008 [German] - Germany
0114-9954/10/1216-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 23 Aug 2008 No. 1216
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