“Two stones on one bird”: A case report on severe biphasic anaphylaxis masquerading as life-threatening acute asthma

Alvin Oliver Payus, Azliza Ibrahim, Norlaila Mustafa

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Anaphylaxis often misdiagnosed and treated as acute asthma, especially when it has a predominant respiratory symptom, and there are no obvious precipitants or previous allergic history. This morbid outcome is preventable if the level of suspicion for anaphylaxis is high among healthcare provider when treating a patient who is not responding to the standard management of acute asthma. A proportion of anaphylactic patient shows a biphasic reaction which potentially fatal when it is under-anticipated and prematurely discharge without adequate observation period after the recovery of the initial episode. CASE REPORT: Here, we present a case of a young man who has childhood asthma with the last attack more than 10 years ago presented with symptoms suggestive of acute exacerbation of bronchial asthma. As the symptoms failed to improve after standard asthma management, anaphylaxis was suspected, and he was given intramuscular adrenaline 0.5 mg which leads to symptom improvement. However, he developed another attack shortly after improvement while under observation. CONCLUSION: The objective of this case report is to emphasise the importance of keeping anaphylaxis in mind whenever a patient has treatment-refractory asthma, and also the anticipation of biphasic reaction that warrants adequate observation period especially those who are likely to have developed it.

Original languageEnglish
Pages (from-to)2136-2138
Number of pages3
JournalOpen Access Macedonian Journal of Medical Sciences
Volume6
Issue number11
DOIs
Publication statusPublished - 25 Nov 2018

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Anaphylaxis
Birds
Asthma
Observation
Diagnostic Errors
Health Personnel
Epinephrine
History

Keywords

  • Acute asthma
  • Anaphylaxis
  • Biphasic reaction
  • Intramuscular adrenaline 0.5 mg
  • Shortness of breath

ASJC Scopus subject areas

  • Medicine(all)

Cite this

“Two stones on one bird” : A case report on severe biphasic anaphylaxis masquerading as life-threatening acute asthma. / Payus, Alvin Oliver; Ibrahim, Azliza; Mustafa, Norlaila.

In: Open Access Macedonian Journal of Medical Sciences, Vol. 6, No. 11, 25.11.2018, p. 2136-2138.

Research output: Contribution to journalArticle

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