Anaphylaxis with delayed appearance of skin manifestations during general anesthesia: two case reports
Abstract Background Anaphylaxis is difficult to diagnose in the absence of skin or mucosal signs and symptoms. We report two cases of anaphylaxis under general anesthesia, in which the initial presentation was in the form of respiratory signs, followed by skin manifestations 10–15 min later. Diagnos...
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| Format: | Article |
| Language: | English |
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BMC
2017-07-01
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| Series: | BMC Research Notes |
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| Online Access: | http://link.springer.com/article/10.1186/s13104-017-2624-7 |
| _version_ | 1818858772970340352 |
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| author | Hiroshi Hanamoto Fumi Kozu Aiko Oyamaguchi Mika Inoue Chizuko Yokoe Hitoshi Niwa |
| author_facet | Hiroshi Hanamoto Fumi Kozu Aiko Oyamaguchi Mika Inoue Chizuko Yokoe Hitoshi Niwa |
| author_sort | Hiroshi Hanamoto |
| collection | DOAJ |
| description | Abstract Background Anaphylaxis is difficult to diagnose in the absence of skin or mucosal signs and symptoms. We report two cases of anaphylaxis under general anesthesia, in which the initial presentation was in the form of respiratory signs, followed by skin manifestations 10–15 min later. Diagnosis of anaphylaxis was delayed because skin symptoms were absent early on in the presentation. Case presentation In the first case, a 23-year-old male patient with jaw deformity was scheduled to undergo maxillary alveolar osteotomy. After intubation, auscultation indicated a sudden decrease in breath sounds, together with severe hypotension. Approximately 10 min later, flushing of the skin and urticaria on the thigh appeared and spread widely throughout the body. In the second case, a 21-year-old female patient with jaw deformity was scheduled to undergo maxillomandibular osteotomy. Twenty minutes after the start of dextran infusion, her lungs suddenly became difficult to ventilate, and oxygen saturation decreased to 90%. Approximately 15 min later, flushing of the skin and urticaria were observed. Conclusion In both cases, there was a time lag between the appearance of respiratory and skin symptoms, which resulted in a delay in the diagnosis, and hence, treatment of anaphylaxis. Our experience highlights the fact that it is difficult to diagnose anaphylaxis under general anesthesia. |
| first_indexed | 2024-12-19T09:01:36Z |
| format | Article |
| id | doaj.art-0b264bb3802f42beaa09697cd0c395ef |
| institution | Directory Open Access Journal |
| issn | 1756-0500 |
| language | English |
| last_indexed | 2024-12-19T09:01:36Z |
| publishDate | 2017-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Research Notes |
| spelling | doaj.art-0b264bb3802f42beaa09697cd0c395ef2022-12-21T20:28:27ZengBMCBMC Research Notes1756-05002017-07-011011510.1186/s13104-017-2624-7Anaphylaxis with delayed appearance of skin manifestations during general anesthesia: two case reportsHiroshi Hanamoto0Fumi Kozu1Aiko Oyamaguchi2Mika Inoue3Chizuko Yokoe4Hitoshi Niwa5Department of Dental Anesthesiology, Osaka University Graduate School of DentistryDepartment of Dental Anesthesiology, Osaka University Graduate School of DentistryDepartment of Dental Anesthesiology, Osaka University Graduate School of DentistryDepartment of Dental Anesthesiology, Osaka University Graduate School of DentistryDepartment of Anesthesiology, Graduate School of Dentistry, Kanagawa Dental UniversityDepartment of Dental Anesthesiology, Osaka University Graduate School of DentistryAbstract Background Anaphylaxis is difficult to diagnose in the absence of skin or mucosal signs and symptoms. We report two cases of anaphylaxis under general anesthesia, in which the initial presentation was in the form of respiratory signs, followed by skin manifestations 10–15 min later. Diagnosis of anaphylaxis was delayed because skin symptoms were absent early on in the presentation. Case presentation In the first case, a 23-year-old male patient with jaw deformity was scheduled to undergo maxillary alveolar osteotomy. After intubation, auscultation indicated a sudden decrease in breath sounds, together with severe hypotension. Approximately 10 min later, flushing of the skin and urticaria on the thigh appeared and spread widely throughout the body. In the second case, a 21-year-old female patient with jaw deformity was scheduled to undergo maxillomandibular osteotomy. Twenty minutes after the start of dextran infusion, her lungs suddenly became difficult to ventilate, and oxygen saturation decreased to 90%. Approximately 15 min later, flushing of the skin and urticaria were observed. Conclusion In both cases, there was a time lag between the appearance of respiratory and skin symptoms, which resulted in a delay in the diagnosis, and hence, treatment of anaphylaxis. Our experience highlights the fact that it is difficult to diagnose anaphylaxis under general anesthesia.http://link.springer.com/article/10.1186/s13104-017-2624-7AnaphylaxisGeneral anesthesiaSkin manifestationsRespiratory symptoms |
| spellingShingle | Hiroshi Hanamoto Fumi Kozu Aiko Oyamaguchi Mika Inoue Chizuko Yokoe Hitoshi Niwa Anaphylaxis with delayed appearance of skin manifestations during general anesthesia: two case reports BMC Research Notes Anaphylaxis General anesthesia Skin manifestations Respiratory symptoms |
| title | Anaphylaxis with delayed appearance of skin manifestations during general anesthesia: two case reports |
| title_full | Anaphylaxis with delayed appearance of skin manifestations during general anesthesia: two case reports |
| title_fullStr | Anaphylaxis with delayed appearance of skin manifestations during general anesthesia: two case reports |
| title_full_unstemmed | Anaphylaxis with delayed appearance of skin manifestations during general anesthesia: two case reports |
| title_short | Anaphylaxis with delayed appearance of skin manifestations during general anesthesia: two case reports |
| title_sort | anaphylaxis with delayed appearance of skin manifestations during general anesthesia two case reports |
| topic | Anaphylaxis General anesthesia Skin manifestations Respiratory symptoms |
| url | http://link.springer.com/article/10.1186/s13104-017-2624-7 |
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