title: Perianesthetic refractory anaphylactic shock with cefuroxime in a patient with history of penicillin allergy on multiple antihypertensive medications.
abstract: We report a case of perianesthetic refractory anaphylactic shock with cefuroxime in a patient with history of penicillin allergy on regular therapy with atenolol, losartan, prazosin and nicardipine. Severe anaphylactic shock was only transiently responsive to 10mL of (1:10,000) epinephrine and needed norepinephrine and dopamine infusion. Supportive therapy with vasopressors and inotropes along with mechanical ventilation for the next 24hours resulted in complete recovery. She was successfully operated upon 2 weeks later with the same anesthetic drugs but intravenous ciprofloxacin as the alternative antibiotic for perioperative prophylaxis.
authors.affiliation: Tata Main Hospital, Department of Anesthesiology and Critical Care, Jamshedpur, India. Electronic address: debsanjay@gmail.com.
authors.forename: Deb Sanjay
authors.initials: DS
authors.lastname: Nag
authors.affiliation: Tata Main Hospital, Department of Anesthesiology and Critical Care, Jamshedpur, India.
authors.forename: Devi Prasad
authors.initials: DP
authors.lastname: Samaddar
authors.affiliation: Tata Main Hospital, Department of Anesthesiology and Critical Care, Jamshedpur, India.
authors.forename: Shashi
authors.initials: S
authors.lastname: Kant
authors.affiliation: Tata Main Hospital, Department of Anesthesiology and Critical Care, Jamshedpur, India.
authors.forename: Pratap Rudra
authors.initials: PR
authors.lastname: Mahanty
mesh_terms: D000707:Anaphylaxis / Q000139:chemically induced*; D000777:Anesthetics / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D002444:Cefuroxime / Q000008:administration & dosage / Q000009:adverse effects*; D004298:Dopamine / Q000008:administration & dosage; D004342:Drug Hypersensitivity / Q000209:etiology; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008875:Middle Aged; D009638:Norepinephrine / Q000008:administration & dosage; D010406:Penicillins / Q000009:adverse effects; D012121:Respiration, Artificial / Q000379:methods
chemical_list: D000777:Anesthetics; D000900:Anti-Bacterial Agents; D000959:Antihypertensive Agents; D010406:Penicillins; D002444:Cefuroxime; D004298:Dopamine; D009638:Norepinephrine; D004837:Epinephrine
keywords: Anafilaxia; Anaphylaxis; Cefuroxima; Cefuroxime; Perianesthetic; Perianestésico