ISSN: 1859 - 2872
Case report: Antibiotic-induced anaphylacxis in a kidney transplant recipient
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Abstract
Anaphylaxis during surgery occurs at an estimated incidence of 1/3,500 to 1/20,000, with a mortality rate of 3 - 9%. Common triggers include antibiotics, neuromuscular blocking agents, contrast agents, chlorhexidine. In transplant recipients, anaphylaxis may lead to more severe consequences due to pre-existing organ dysfunction and/or resuscitation procedures that may compromise graft perfusion. We report a case of grade III anaphylaxis caused by the antibiotic Ceftriaxone(Rocephine) in a living-donor kidney transplant recipient, presented with tachycardia (120 beats/min), severe hypotension (nadir blood pressure was 64/32 mmHg), and generalized urticarial rash. The patient was resuscitated according to standard protocols, including fluid replacement, hemodynamic-targeted adrenaline infusion, and local management of iliac vasospasm with lidocaine and papaverine. Surgery was continued, and post-transplant renal function improved, reaching normal levels by postoperative day 3. Conclusion: Detected Grade III anaphylaxis during anesthesia in a renal transplant patient, assessed based on hemodynamic changes and cutaneous–mucosal manifestations. Prompt treatment with adrenaline was administered. Once the anaphylactic symptoms subsided, hemodynamics stabilized, and adequate perfusion through the graft vessels was confirmed, the decision was made to proceed with kidney transplantation, with close monitoring for possible biphasic anaphylaxis.
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References
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