J Korean Dent Soc Anesthesiol.  2014 Dec;14(4):243-250. 10.17245/jkdsa.2014.14.4.243.

Anaphylactic Shock after Intravenous Injection of Penicillin in a Patient with Maxillary Osteonecrosis: Report of a Case

• Oh JH
• Son JS
• Choi BH
• Lee JS
• Kim JH
• Yoo JH

• KMID: 2344986
• DOI: http://doi.org/10.17245/jkdsa.2014.14.4.243

Abstract

Generalized anaphylaxis is a most dramatic and acutely life-threatening allergic reaction and may cause death within a few minutes. Differential diagnosis of anaphylaxis is made by clinical signs, such as, mental change, respiratory distress, hypotension, hypoglycemia, urticaria and angioedema. Especially, insulin reaction, myocardial infarction and vasovagal syncope are considered as differential diagnosis. In cases of fatal anaphylaxis, respiratory and cardiovascular disturbances predominate and are evident early in the reaction. This is a case report of the intensive care of anaphylactic shock after intravenous injection of the penicillin in a old medically compromised patient with the maxillary osteonecrosis. The anaphylactic shock symptoms, such as, unconsciousness, respiratory disorder, no pulsation on carotid artery and cardiopulmonary arrest are occurred in intravenous injection of augmentin 1.2 g after the skin test. In spite of immediate emergency cares, such as intravenous injection of epinephrine, endotracheal intubation, cardiopulmonary resuscitation, and continuous intensive care, the patient is expired in 58 hours after anaphylactic shock attack.

Keyword

Anaphylactic shock; Cardiopulmonary resuscitation; Epinephrine; Maxillary osteonecrosis; Penicillin

MeSH Terms

Amoxicillin-Potassium Clavulanate Combination
Anaphylaxis*
Angioedema
Cardiopulmonary Resuscitation
Carotid Arteries
Critical Care
Diagnosis, Differential
Emergencies
Epinephrine
Heart Arrest
Humans
Hypersensitivity
Hypoglycemia
Hypotension
Injections, Intravenous*
Insulin
Intubation, Intratracheal
Myocardial Infarction
Osteonecrosis*
Penicillins*
Skin Tests
Syncope, Vasovagal
Unconsciousness
Urticaria
Amoxicillin-Potassium Clavulanate Combination
Epinephrine
Insulin
Penicillins