Gaspar-Marques J, Finelli E, Martins P C, Prates S, Leiria-Pinto P
Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, Lisbon, Portugal; CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Lisbon, Portugal.
Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.
Eur Ann Allergy Clin Immunol. 2018 Mar;50(2):89-91. doi: 10.23822/EurAnnACI.1764-1489.29. Epub 2017 Nov 20.
Piperacillin is a beta-lactam antibiotic of penicillin family. Some penicillins were report-ed as occupational diseases cause, but piperacillin anaphylaxis with occupational sensi-tization is rare. We describe the case of a female nurse with recurrent anaphylaxis in last few months without apparent cause, only in work environment. Latex allergy was excluded after negative latex glove provocation. Later during diagnostic workup, the patient reported a similar reaction minutes after piperacillin preparation. She denied any previous antibiotic therapeutic exposure. Skin prick tests (SPT) to beta-lactams were positive to piperacillin, penicillin G and major and minor determinants. SPT to cefuroxime was negative but intradermic test was positive. The patient has indication for beta-lactams eviction and for adrenaline auto-injector kit. No further reactions occurred after patient's transfer to another department with minimum possible exposure. Allergic risk prevention is essential and must be rapidly implemented to avoid incapacitating occupational diseases development.
哌拉西林是一种青霉素类的β-内酰胺抗生素。一些青霉素曾被报道为职业病病因,但因职业致敏导致的哌拉西林过敏反应罕见。我们描述了一名女性护士的病例,她在过去几个月里反复出现无明显诱因的过敏反应,且仅在工作环境中发生。乳胶手套激发试验阴性后排除了乳胶过敏。在后续诊断检查中,患者报告在配制哌拉西林几分钟后出现类似反应。她否认既往有任何抗生素治疗暴露史。对β-内酰胺类药物的皮肤点刺试验(SPT)显示对哌拉西林、青霉素G以及主要和次要决定簇呈阳性。对头孢呋辛的SPT为阴性,但皮内试验为阳性。该患者有停用β-内酰胺类药物并配备肾上腺素自动注射器的指征。患者转至另一个尽可能减少暴露的科室后未再出现反应。预防过敏风险至关重要,必须迅速实施以避免发展为致残性职业病。