It is the most dramatic and acutely life-threatening allergic reaction where clinical death can occur within a few minutes. The most common cause of death from anaphylaxis are parenterally administered penicillin and stinging insects ( wasps, yellow jackets and bees).


It is caused due to IgE mediate type -I hypersensitivity reaction. IgE binds to immune complex and releases histamine in response to the trigger allergens(food, insects) and in turn, causes symptoms such as swelling, difficulty in breathing and inflammatory mediators.


  • Milk
  • Egg
  • Wheat
  • Peanuts
  • Tree nuts
  • Penicillin
  • Muscle relaxants
  • Anti-seizure medications
  • Pollen
  • Stings from bees, wasps
  • Latex


  • Skin reactions include intense itching, erythema, urticaria, conjunctivitis, rhinitis, pilomotor erection.
  • Nausea, vomiting
  • Abdominal cramps
  • Diarrhea
  • Cough
  • Wheezing dyspnoea
  • Cyanosis
  • Laryngeal edema
  • Tachycardia
  • Hypotension
  • Unconsciousness
  • Cardiac arrest


  • Diagnosis can be easily confirmed by the asking the type of allergen that caused it and by asking the symptoms mentioned above by the doctor itself.


  • Administer epinephrine -0.3ml of 1:1000 I.M.
  • Summon medical assistance in a severe allergic reaction by activating emergency medical service.
  • If the clinical picture fails to improve within 5-10 mins of the initial epinephrine dose, a second dose is administered.
  • Administer oxygen.
  • Monitor vital signs like blood pressure, heart rate (at the carotid artery) should be recorded at least every 5 minutes with chest compression started if no palpable pulse is detected by the professional.
  • Administration of a histamine blocker and a corticosteroid (I.M or I.V) is also effective in controlling edema.
  • Surgery is an emergency procedure to secure patent airway known as cricothyrotomy.

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