Intravenous infusion of leucomycin caused one case of anaphylactic shock, with a negative test result. Intravenous infusion of compound sodium chloride 25C, mi plus sodium penicillin 6.4 million u, 3o Exile/min. Three minutes after, the patient suddenly felt severe stomach pain, dry throat, and throat tightness. Examination: blood pressure 16/llkPa, breathing 20, facial and body skin pedaled red. Positive skin pack scratches, lips, abercrombie fitch deutschland, hair crucible, lung (0), heart rate 108 times, the whole law distal extremities warm. Immediate termination of intravenous infusion, oxygen provided. 25% glucose 2oral plus dexamethasone 10mg intravenous 654-2-2lOmg, non Flanagan 25rag intramuscular, 20 minutes after the relief of symptoms. Prognosis without adverse reactions.
A second male patient, 45 years old, was admitted to the hospital due to upper respiratory tract infection. Penicillin skin test was negative, with intravenous infusion of 5V sugar brine 2SOre plus sodium penicillin 6.4 million u. Ten minutes later, the patient experienced itching all over the body while remaining conscious. The infusion was immediately stopped. Blood pressure was 20/12kPa, pulse 90/. Facial flushing. Body groups like wind urticaria. Trunk weight, heart and lung (0). Distal extremities warm. Immediately given phenergan 25rag intramuscular, the l0 calcium gluconate 2Oral intravenously. Groups like wind urticaria disappeared after half an hour. No adverse reaction pre-brow.
Discussion: The above two cases are inverted due to upper respiratory tract infection treated with intravenous penicillin. Penicillin skin tests were negative before treatment, and allergic reactions occurred ~10 minutes after medication administration, such as urticaria-like changes, for example, accompanied by severe abdominal pain, normal blood pressure and heart rate except for - distal extremities warm can rule out shock. Conventional de-shock treatment relieved the symptoms soon, with a good prognosis. Skin test towers in an allergic reaction when a large dose of medication - penicillin allergic reaction theory cannot explain this. I believe that in the penicillin Guo Ji reaction threshold. Not everyone’s same amount of penicillin can induce Guo Ji reaction. Some conventional skin tests (penicillin 500U/m1) provoke allergic reactions in clinical settings, and even smelling the penicillin odor can cause - some decadent can provoke allergic reactions in hundreds of thousands of u, the majority have no allergic reactions. When the clinical epithelial test is negative, increasing the dose of the posterior arch [sudden allergic reaction phenomenon can only be explained by different thresholds. Threshold determines whether a clinical allergic reaction occurs and the time of onset. Literature reports cases of anaphylactic shock and even death within a few minutes after a negative skin test followed by large doses of medication. This paper reports Guo Ji reaction relatively '25' light, the threshold is more reasonable to explain this phenomenon.