Lidocaine hypersensitivity after subconjunctival injection.
METHODS
We report a rare case of hypersensitivity in a 63-year-old man who received subconjunctival lidocaine, cefazolin, and gentamicin for corneal abscess. Significant palpebral swelling and erythema were observed several hours after the injection. Nine months later, he received subconjunctival lidocaine, vanco-mycin, and ceftazidime for a new corneal abscess. After several hours, the eyelids were red and swollen, with mild blistering and scaling of the cheek. Two patch tests for lidocaine were negative. During follow-up, lateral tarsorrhaphy was performed under local anesthesia with lidocaine; erythema and swelling of eyelids and cheek appeared, resolving after several days.


CONCLUSIONS
Sensitivity to lidocaine can appear after subconjunctival injection. Patch tests may be negative, but the allergy suspected by the recurrence of clinical signs after rechallenge with lidocaine. Ester anesthetics can be used for local anesthesia.
Levy
Jaime
J
Department of Ophthalmology, Soroka University Medical Center, Beer-Sheva, Israel. ljaime@bgu.ac.il
Lifshitz
Tova
T
D000038:Abscess / Q000188:drug therapy; D000779:Anesthetics, Local / Q000009:adverse effects*; D003228:Conjunctiva / Q000187:drug effects; D003316:Corneal Diseases / Q000188:drug therapy; D004342:Drug Hypersensitivity / Q000209:etiology*; D006801:Humans; D007267:Injections; D008012:Lidocaine / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010328:Patch Tests; D012008:Recurrence
D000779:Anesthetics, Local; D008012:Lidocaine