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Query: UMLS:C0042109 (urticaria)
 6,569 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One hundred and forty four patients, with dermal reactions to different drugs, were chosen from our clinic. The selection criteria was based on a detailed and careful anamnesis in order to be certain of the specific drug responsible for the reaction. We tried to establish a drug-specific reaction pattern for each of the drugs studied. Intradermal skin tests were performed with all drugs to be studied, except with pyrazolones and aspirin, for which patch tests were applied. The drug concentrations were established prior to the tests in order to avoid unwanted unspecific reactions. In every case, immediate and delayed reaction readings were carried out. A three crosses reaction (+++) was considered positive. The skin tests were positive in 44% of the cases, a value higher than those referred to by most authors. The delayed reactions to skin tests and the chloramphenicol-mediated delayed-type "dermatitis-like" manifestations are compared. It is noteworthy to mention that positive delayed reactions were observed more frequently with chloramphenicol than with any of the other studied drugs. The same applies for those patients with a positive history to chloramphenicol. The most common reaction pattern to penicillin and streptomycin in our series (20%) were urticaria and Quincke's edema. Penicillin, pyrazolones and streptomycin were the most common drugs responsible for urticarial patterns, being the pyrazolones related to fixed erythema in many cases. The age group 25-50 was the most frequently involved. No sex predominance was observed. The value of the classic skin tests is discussed, so are history recording and the in vitro tests.
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PMID:[Study of drug allergies with special reference to skin manifestations]. 13 Jul 96

The author reviewed 2000 clinical records of his private allergy patients chosen at random. 197 records (9.7%) labeled "allergic to aspirin" were culled. 41 (2.1%) were acute cases and 153 (7.6%) had a history of "intolerance to aspirin". The main symptoms were angioedema or angioedema and urticaria in the majority of patients. No deaths were recorded. Each clinical record was surveyed and 61% of the acute cases and 72% of the patients with a history of intolerance to aspirin had a personal history of atopy. Family history of atopy was present in 63 and 73%, respectively. There was no history of atopy in 12% of the acute cases and in 7% of those with a history of intolerance to aspirin. 56 to 65% of these groups, respectively, had allergic rhinitis and 17 and 34%, had asthma. 23% of these patients showed allergic reactions simultaneously to Pyrazolones and between 12 and 22% showed allergy to Penicillin, and between 2 and 12%, to Acetominophene. The only food to which statistically significant allergy occurred was pancake, in 12%. 53% of the acute cases and 89% of those with a history of intolerance to aspirin showed a pseudoallergic reaction with products which contain aspirin or non steroidal antiinflamatory agents. 80% of the acute cases were treated with aqueous 1:1000 solution of epinephirine subcutaneously. 100% were given antihistaminics I.M. or orally and 61% were given steroids. Each patient was furnished with a list of the main aspirin containing products and non steroidal antiinflammatory agents, which cross react with aspirin.
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PMID:[Aspirin. Pseudo-allergic reactions]. 266 39

Penicillin is known to cause allergic reactions with different clinical manifestations and possible immunologic mechanisms. The purpose of this study was to follow cases of established hypersensitivity to penicillin and its possible development into chronic urticaria. 35 patients with a clinical picture of acute urticaria and with or without angioedema were examined. Three kinds of tests to penicillin were performed: patch test, scarification test and PPL test. Hypersensitivity to penicillin was confirmed in 12 (34.27%) patients with positive PPL test. Seven (58.33%) out of these 12 developed the clinical picture of chronic urticaria. As food was assumed to be the hidden source of penicillin, eliminatory diet was included. In 4 (57.14%) patients there was a complete remission of the disease during the course of diet without milk and milk products (intradermal test to milk and specific IgE antibodies were negative). The gathered results show that acute urticaria caused by penicillin can get a chronic character. It is the consequence of prolonged penicillin's activity in some so called "hidden sources of penicillin".
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PMID:[Chronic urticaria caused by penicillin. Results of monitoring cases of acute penicillin urticaria which developed into chronic urticaria]. 865 64

Patients frequently state that they have a penicillin allergy that often presents a therapeutic problem in treating a variety of infectious disorders. Penicillin and beta-lactam allergic reactions should be determined by a careful history. Many patients who say they have a penicillin allergy, in fact do not. If it is determined that the patient has a penicillin allergy, then the clinician should determine whether it is of an anaphylactic or nonanaphylactic variety. Most reactions to beta-lactams are of the nonanaphylactic variety and are usually manifested clinically as a mild maculopapular rash or drug fever. Uncommonly, penicillin allergies are clinically manifested as anaphylactic reactions, e.g., bronchospasm, laryngospasm, hypotension or hives. Patients' hypersensitivity reactions tend to be stereotyped on rechallenge, which make the reactions predictable. Patients who have a questionable penicillin allergy, or have had only fever or rash, may be safely given beta-lactam antibiotics without fear of anaphylaxis. Patients with a documented history of anaphylactic reactions should receive non-beta-lactam antibiotics. Although monobactams and carbapenems are structurally related to beta-lactams, they are unrelated in terms of allergic potential. There is no cross-reactivity between mono-bactams or carbapenems with beta-lactams, and these drugs may be used safely in patients with anaphylactic reactions to beta-lactams. Because so many antibiotics are available that are allergically unrelated to beta-lactams, beta-lactam desensitization procedures are rarely necessary. (c) 2001 Prous Science. All rights reserved.
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PMID:Antimicrobial selection in the penicillin-allergic patient. 1276 24

We report a case of sudden hearing loss in a patient with acute exudative tonsillitis, occurring 15 minutes after the intramuscular administration of penicillin. Audiological evaluation documented a profound sensorineural hearing loss of the cochlear type. The mechanism of the hearing loss was probably an immediate hypersensitivity (type I) allergic drug reaction. Penicillin is used frequently for the treatment of several infections. Allergic reactions to penicillin are well known and include urticaria, maculopapular exanthems, angio-oedema, bronchospasm and anaphylaxis, but sudden hearing loss has never been recorded.
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PMID:Sudden sensorineural hearing loss following intramuscular administration of penicillin. 1497 53

Estimates on the cross-reactivity between cephalosporin and penicillin range from 1 to 16%. Patients with a history of penicillin allergy usually receive less optimal and more costly alternatives even if cephalosporins are a more viable alternative. One hundred eighty-six patients admitted to Winthrop University Hospital in a 7.5-month period, who reported penicillin allergy and received cephalosporin, were sent surveys. Eighty-three patients completed the survey and their charts were reviewed. Seven of 83 patients (8.4%) from a larger group of 186 penicillin-allergic patients developed a reaction to a cephalosporin. The exact 95% confidence interval is 3.5-16.6%. Six of seven (85.7%) penicillin-allergic patients who reacted to cephalosporin reported a definite history of an immediate reaction to penicillin, including hives. Only 1 of 62 (1.6%) patients who reported that their penicillin reaction was delayed, probable, or unknown had a cephalosporin reaction (p < 0.001). Thirty percent (3 of 10 patients) of penicillin-allergic patients, who received a second-generation cephalosporin, had a reaction, whereas 5.5% (4 of 73 patients) of those patients given only a first-, third-, and fourth-generation cephalosporin reacted (p < 0.04). None of those patients who received a fourth-generation cephalosporin reacted. Four of 15 (26.7%) patients who received a cephalosporin with an amino benzyl ring developed a reaction, as compared with 3 of 68 (4.4%) patients who received a cephalosporin without the ring (p < 0.02). Four patients with severe cephalosporin reactions had a rash, shortness of breath, difficulty swallowing, lightheadedness, and anaphylaxis. Patients who recall a definite history of an immediate type of penicillin allergy are more likely to develop a cephalosporin reaction compared with patients who reported a delayed, a probable, or an unknown penicillin reaction. Penicillin-allergic patients who receive second-generation cephalosporins, especially those with an amino benzyl side chain, are more likely to develop a reaction to cephalosporin. Although the incidence of reactions to cephalosporin in penicillin-allergic patients is low, those patients who reacted had more severe manifestations including anaphylaxis. Thus, continued caution regarding administration of cephalosporin, especially those with amino benzyl side chains, to patients who have a definite history of an immediate reaction to penicillin is advised.
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PMID:Adverse drug reactions to a cephalosporins in hospitalized patients with a history of penicillin allergy. 1597 73