Occupational generalized urticaria and anaphylaxis after inhalation of cefuroxime in a nurse |
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Authors: | Rolf Merget MD Ingrid Sander PhD Manigé Fartasch MD Vera van Kampen PhD Stefani Röseler MD Hans Merk MD Gerda Wurpts MD Monika Raulf PhD Thomas Brüning MD |
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Affiliation: | 1. Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany;2. Department of Dermatology and Allergology, University Hospital Aachen, Aachen, Germany |
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Abstract: | We present the case of a 53 years old nonatopic female nurse who experienced repeated anaphylactic reactions at work without involvement in drug‐specific tasks such as crushing of tablets or preparation of injections. The causal allergen was not identified until a further severe anaphylactic reaction occurred after oral use of cefuroxime during a respiratory infection. Sensitization to cefuroxime was demonstrated by specific IgE, basophil activation test and skin prick test. An inhalation challenge with a dosimeter induced generalized urticaria after a cumulative dose of about 10 μg of the drug, but no asthmatic reaction. Complete exposure cessation was initiated and a 1‐year follow‐up was without further allergic reactions. We conclude that work‐related systemic allergic reactions to β‐lactam antibiotics may occur in nurses after inhalation of low doses and without perceived association with drug‐specific tasks like handling of antibiotics. |
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Keywords: | allergy anaphylaxis cephalosporins nurse occupational |
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