[Anaphylactic shock associated with ceftriaxone therapy in a newborn]

Fatal Anaphylactic Shock Ceftriaxone-Induced in a 4-Year-Old Child

One of the most used cephalosporin in clinical practice is ceftriaxone. Anaphylaxis due to the administration of ceftriaxone is considered a rare event. Here, we report a case of fatal anaphylactic shock after the administration of ceftriaxone in a child who had tolerated the drug in past exposures. The allergic pathogenesis is sustained by the clinical data (short time between the inoculation of the drug and the onset of the symptoms; past exposure to the same molecule and probable sensitization) and the postmortem examination findings (polivisceral congestion and intense eosinophilia found in the histological examination).

Levetiracetam-induced anaphylaxis in a neonate

BACKGROUND

Neonatal seizures are often refractory to treatment with initial antiseizure medications. Clinicians turn to agents such as levetiracetam despite the paucity of published data regarding its safety, tolerability, or efficacy in the neonatal population.

PATIENT PRESENTATION

We describe a neonate who developed anaphylactic shock developing after receiving intravenous levetiracetam.

RESULTS

This is the first neonate to develop anaphylactic shock due to intravenous administration of levetiracetam.

CONCLUSION

Clinicians should be aware of this potentially fatal adverse effect occurring with intravenous levetiracetam in newborns.

Anaphylactic shock due to vitamin K in a newborn and review of literature

Newborn infants are born with an immature innate immunity. They are less likely to develop anaphylaxis since their immune system is weaker than older infants and children. There are only a few reports of side effects after vitamin K injection in neonates although prophylaxis against hemorrhagic disease of the newborn with this drug has been in routine practice in all over the world for many years. We herein report a case of anaphylactic shock developing after the intramuscular administration of vitamin K1 in a newborn. To our knowledge, this patient is the first case of neonatal anaphylactic shock developing due to intramuscular administration of vitamin K1. We suggest the clinicians should be aware of this possibility of potentially fatal adverse effect occurring with intramuscular administration of vitamin K1.

Cefotaxime-induced near-fatal anaphylaxis in a neonate: A case report and review of literature

A case of 7-day-old male neonate with cefotaxime-induced near-fatal anaphylaxis is being reported. Child was started on intravenous cefotaxime on day 3 of life in view of early-onset sepsis with pneumonia, following which there was clinical improvement. Child was then shifted out of intensive care to general ward for completion of antibiotic course. One day prior to the planned discharge, child suddenly developed poor sensorium, flaccidity, apnea, and cyanosis within seconds of receiving intravenous cefotaxime and was found to have bradypnea with bradycardia. Prompt resuscitation was carried out with artificial ventilation, adrenaline, and steroids. Spontaneous breathing reappeared and the clinical condition improved.