title: Anaphylactic reaction 5 minutes after the start of surgery: a case report.
abstract: BACKGROUND
  Natural latex rubber products have been known to cause severe anaphylactic reactions during surgery. Even 25 years after the first description of anaphylactic reactions in the literature, natural latex rubber products are still used in pediatric surgery.
  
  
  METHODS
  The following article describes the case of a healthy 4.5-year old Caucasian boy who simultaneously developed severe hypotension, tachycardia and bronchospasm during surgery for congenital strabismus sursoadductorius under uneventful anesthesia. An allergy test conducted afterwards showed natural latex rubber as the trigger for this severe intraoperative anaphylactic reaction. This case was special because of the absence of any previous clinical or anamnestical evidence of natural latex rubber allergy. The fact that the child had been previously exposed to natural latex rubber - because the boy's mother used disposable gloves for her work as a cosmetician at home - was only discovered later. Such contact may have had a slight sensitizing effect that manifested after the initial contact with the conjunctiva through the surgeon's natural latex rubber gloves.
  
  
  CONCLUSIONS
  Natural latex rubber products have caused severe anaphylactic reactions time and again. Diagnosis is impeded by the highly variable clinical symptoms of anaphylaxis, the non-responsivity of patients, anesthesia-induced changes in blood pressure, surgical drapes, and blood loss. Therefore, use of alternative products and implementation of the right course of action in clinical routine seems to be even more important than raising awareness for allergies to natural latex rubber.
authors.affiliation: Department of Anesthesiology, University Medical Center Regensburg, Franz Josef Strauss Allee 11, 93053, Regensburg, Germany. Manuela.Malsy@ukr.de.
authors.forename: Manuela
authors.initials: M
authors.lastname: Malsy
authors.affiliation: Department of Anesthesiology, University Medical Center Regensburg, Franz Josef Strauss Allee 11, 93053, Regensburg, Germany. Richard.Leberle@ukr.de.
authors.forename: Richard
authors.initials: R
authors.lastname: Leberle
authors.affiliation: Department of Anesthesiology, University Medical Center Regensburg, Franz Josef Strauss Allee 11, 93053, Regensburg, Germany. Katharina.Ehehalt@ukr.de.
authors.forename: Katharina
authors.initials: K
authors.lastname: Ehehalt
authors.affiliation: Department of Anesthesiology, University Medical Center Regensburg, Franz Josef Strauss Allee 11, 93053, Regensburg, Germany. Barbara.Sinner@ukr.de.
authors.forename: Barbara
authors.initials: B
authors.lastname: Sinner
authors.affiliation: Department of Anesthesiology, University Medical Center Regensburg, Franz Josef Strauss Allee 11, 93053, Regensburg, Germany. Jonny.Hobbhahn@ukr.de.
authors.forename: Jonny
authors.initials: J
authors.lastname: Hobbhahn
mesh_terms: D000707:Anaphylaxis / Q000209:etiology*; D002675:Child, Preschool; D006801:Humans; D020315:Latex Hypersensitivity / Q000150:complications*; D008297:Male; D013514:Surgical Procedures, Operative / Q000009:adverse effects*