[Anaphylactic shock to iodinated povidone].

Area of Science:

• Anesthesiology
• Allergy and Immunology
• Dermatology

Background:

• Anaphylaxis during anesthesia is uncommon, typically associated with neuromuscular blocking agents, latex, or antibiotics.
• Hidden allergens can also trigger anaphylaxis, posing diagnostic challenges.
• Povidone, a widely used antiseptic and cosmetic ingredient, is rarely implicated.

Observation:

• A patient experienced a severe (grade 3) anaphylactic shock.
• The reaction occurred following the rectal administration of iodinated povidone.
• This route of administration and allergen are exceptionally rare causes of anaphylaxis.

Findings:

• Iodinated povidone can act as a potent allergen, leading to severe anaphylactic reactions.
• Rectal administration of povidone presents a unique pathway for allergen exposure.
• The case underscores the importance of considering less common allergens and administration routes in diagnosing anaphylaxis.

Implications:

• Clinicians should consider povidone as a potential allergen in unexplained anaphylaxis, even with unusual administration routes.
• Further investigation into povidone allergy mechanisms and risk factors is warranted.
• This case expands the differential diagnosis for anaphylaxis in perioperative settings.