title: Delayed Anaphylaxis to Mammalian Meat Following Tick Exposure and Its Impact on Anesthetic Management for Cardiac Surgery: A Case Report.
abstract: Hypersensitivity reactions to mammalian meat following tick exposure are increasing in prevalence and provide a unique challenge to anesthesiologists. The reactions, including anaphylaxis, are delayed and therefore may not be easily recognized and treated. The risk is especially high in cardiac surgery, where several potential triggers, including biological valves as well as heparin, are used frequently. In the presence of such hypersensitivity, prophylactic measures including preoperative testing and pharmacologic prophylaxis may be useful in modulating the immune response such that triggering agents may be used relatively safely. We present 3 patients with previous sensitization to meat protein following a tick bite with known allergic reactions to mammalian meat who presented for cardiac surgery involving exposure to potential allergens and discuss the perioperative management including possible prevention.
authors.affiliation: From the Department of Anesthesiology, University of Virginia Health System, Charlottesville, Virginia.
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Kleiman
authors.forename: Keith E
authors.initials: KE
authors.lastname: Littlewood
authors.forename: Danja S
authors.initials: DS
authors.lastname: Groves
mesh_terms: D000328:Adult; D000368:Aged; D000707:Anaphylaxis / Q000139:chemically induced / Q000276:immunology*; D000777:Anesthetics / Q000009:adverse effects*; D001024:Aortic Valve Stenosis / Q000601:surgery; D001281:Atrial Fibrillation / Q000601:surgery; D006348:Cardiac Surgical Procedures / Q000379:methods; D005260:Female; D005512:Food Hypersensitivity / Q000209:etiology* / Q000276:immunology; D006801:Humans; D008297:Male; D008460:Meat / Q000009:adverse effects; D064927:Tick Bites / Q000276:immunology*
chemical_list: D000777:Anesthetics