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Anaphylaxis to topical bacitracin zinc ointment
J A Saryan1, T C Dammin, A E Bouras
1Department of Allergy and Immunology, Lahey Hitchcock Medical Center, Burlington, MA 01805, USA.
The American Journal of Emergency Medicine
|September 3, 1998
Summary
A motorcycle accident patient experienced severe anaphylaxis from bacitracin zinc ointment. Skin testing confirmed bacitracin as the allergen, highlighting its potential for acute allergic reactions.
Area of Science:
- Allergy and Immunology
- Dermatology
- Pharmacology
Background:
- Topical antibiotics are commonly used for skin injuries.
- Bacitracin zinc ointment is a frequent choice for wound care.
- Systemic allergic reactions to topical agents are rare but serious.
Observation:
- A 24-year-old male developed severe anaphylaxis minutes after bacitracin zinc ointment application to abrasions.
- The patient required immediate emergency treatment including epinephrine and corticosteroids.
- Subsequent skin testing confirmed bacitracin zinc ointment as the sole trigger for the allergic reaction.
Findings:
- The case demonstrates an acute IgE-mediated hypersensitivity reaction to bacitracin zinc.
- Prick testing was positive for bacitracin zinc ointment, while other tested agents were not.
- This reaction occurred despite bacitracin's general reputation as a safe topical antibiotic.
Implications:
- Healthcare providers must consider the potential for severe allergic reactions, including anaphylaxis, to topical bacitracin.
- Awareness of IgE-mediated hypersensitivity is crucial for managing patients with unexplained anaphylaxis after topical agent use.
- This case underscores the importance of thorough allergy assessment in wound management.