Anaphylaxis and Undiagnosed Aspirin Exacerbated Respiratory Disease in the Ambulatory Surgery Center: A Case Report

Jennifer Wu

Department of Anesthesiology, University of Texas Health Science Center Houston, Houston, Texas.

DOI: 10.4236/ojanes.2015.512043                

Abstract

Severe bronchospasm and anaphylaxis are unanticipated emergencies that may occur in the ambulatory surgery setting. I present a case in which an asthmatic male with nasal congestion has anaphylaxis after induction, with severe bronchospasm as the primary manifestation. During the course of hospitalization, he was exposed to aspirin and a second episode of severe bronchospasm occurred. He was diagnosed with both anaphylaxis to an anesthetic medication and Aspirin Exacerbated Respiratory Disease, or Samter’s Triad.

Keywords

Ambulatory Anesthesia, Bronchospasm, Anaphylaxis, Anaphylactoid, Samter’s Triad, Aspirin Exacerbated Respiratory Disease

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Levy, J.H. and Adkinson Jr., N.F. (2008) Anaphylaxis during Cardiac Surgery: Implications for Clinicians. Anesthesia & Analgesi, 106, 392-403. http://dx.doi.org/10.1213/ane.0b013e3181602e0d
[2]	Mertes, P.M. and Laxenaire, M.C. (2004) Allergy and Anaphylaxis in Anaethesia. Minerva Anestesiologica, 70, 285-291.
[3]	Johnson, R.F. and Peebles, R.S. (2004) Anaphylactic Shock: Pathophysiology, Recognition, and Treatment. Seminars in Respiratory and Critical Care Medicine, 25, 695-703. http://dx.doi.org/10.1055/s-2004-860983
[4]	Peavy, R.D. and Metcalfe, D.D. (2008) Understanding the Mechanisms of Anaphylaxis. Current Opinion in Allergy & Clinical Immunology, 8, 310-314. http://dx.doi.org/10.1097/ACI.0b013e3283036a90
[5]	Hepner, D.L. and Castells, M.C. (2003) Anaphylaxis during the Perioperative Period. Anesthesia & Analgesi, 97, 1381-1395. http://dx.doi.org/10.1213/01.ANE.0000082993.84883.7D
[6]	Dewachter, P., Mouton-Faivre, C. and Emala, C.W. (2009) Anaphylaxis and Anesthesia: Controversies and New Insights. Anesthesiology, 111, 1141-1150. http://dx.doi.org/10.1097/ALN.0b013e3181bbd443
[7]	Dewachter, P., Mouton-Faivre, C., Emala, C.W., Beloucif, S. and Riou, B. (2011) Case Scenario: Bronchospasm during Anesthetic Induction. Anesthesiology, 114, 1200-1210. http://dx.doi.org/10.1097/ALN.0b013e3182172cd3
[8]	Kim, J.E. and Kountakis, S.E. (2007) The Prevalence of Samter’s Triad in Patients Undergoing Functional Endoscopic sinus Surgery. Ear, Nose & Throat Journal, 86, 396-399.
[9]	Settipane, R.A., Schrank, P.J., Simon, R.A., Mathison, D.A., Christiansen, S.C. and Stevenson, D.D. (1995) Prevalence of Cross-Sensitivity with Acetaminophen in Aspirin-Sensitive Asthmatic. Journal of Allergy and Clinical Immunology, 96, 480-485. http://dx.doi.org/10.1016/S0091-6749(95)70290-3