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Allergy Asthma Proc. 2004 Jan-Feb;25(1):23-6.

Perioperative anaphylaxis to cefazolin.

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Harvard Medical School, Department of Medicine, Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, Massachusetts, USA.


The incidence of generalized reactions during anesthesia has been reported to range from 1 in 5000 to 1 in 25,000 cases with a mortality rate of up to 6%. The most common causes are neuromuscular blocking agents, latex, and antibiotics. Identification of the offending agent may be difficult because multiple medications are administered over a short period. Furthermore, up to 40% of all generalized reactions during anesthesia are non-immunoglobulin E mediated and therefore can not be evaluated by skin testing. We report a case of perioperative anaphylaxis to cefazolin. Sensitization to cefazolin was determined through skin testing, and the patient underwent successful surgery subsequently with the avoidance of cefazolin.

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