Anaphylaxis in labor secondary to prophylaxis against group B Streptococcus. A case report

Two strategies have been recommended by the Centers for Disease Control and Prevention and approved by the American College of Obstetrics and Gynecology to help prevent group B streptococcal disease in the newborn. Both involve using penicillin in labor. However, the potential for allergic and even anaphylactic reactions to penicillin exists.

A patient was treated for risk factors for group B Streptococcus in labor and suffered a serious anaphylactic reaction to penicillin; it resulted in an emergency cesarean section. Although the patient and infant were eventually discharged, the patient developed disseminated intravascular coagulation and suffered acute tubular necrosis that required dialysis.

Prophylaxis against group B streptococcal sepsis is of proven benefit, but the possible harm to the mother and fetus from treatment with penicillin must be recognized.