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penicillin allergy

ICD-10 Codes

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Description

What is Penicillin Allergy?

Penicillin allergy is an abnormal reaction of your immune system to the antibiotic drug penicillin. This allergic reaction can manifest in various ways, ranging from mild symptoms to life-threatening conditions.

Common Signs and Symptoms:

  • Hives
  • Rash
  • Itching
  • Swelling

These symptoms can occur quickly, usually within an hour of taking the medicine. In some cases, a penicillin allergy can result in more severe reactions, such as:

  • Anaphylaxis (a life-threatening condition that affects multiple body systems)
  • Respiratory symptoms like wheezing, coughing, and difficulty breathing
  • Tightness in the throat

Incidence of Penicillin Allergy:

A penicillin allergy is a common allergy, affecting approximately 10% of all U.S. patients who report having an allergic reaction to a penicillin class antibiotic in their past [10]. However, many patients who report penicillin allergies do not have true IgE-mediated reactions, with fewer than 1% of the population actually experiencing this type of allergy [10].

Other Related Information:

  • Penicillin is still one of the most widely prescribed antibiotics and has been used since its discovery by Alexander Fleming in 1928 [5].
  • The penicillin family of antibiotics includes various derivatives, such as amoxicillin and piperacillin-tazobactam [12].

References:

[1] Context result 2 [3] Context result 3 [10] Context result 10 [12] Context result 12

Additional Characteristics

  • Hives
  • Rash
  • Swelling
  • Itching
  • Tightness in the throat
  • Penicillin allergy is an abnormal reaction of your immune system to the antibiotic drug penicillin.
  • Anaphylaxis (a life-threatening condition that affects multiple body systems)
  • Respiratory symptoms like wheezing, coughing, and difficulty breathing

Signs and Symptoms

Common Signs and Symptoms of Penicillin Allergy

A penicillin allergy can manifest in various ways, ranging from mild to severe reactions. Here are some common signs and symptoms:

  • Skin-related issues: Hives, rash, itching, and swelling are common skin-related symptoms of a penicillin allergy.
  • Respiratory problems: Coughing, wheezing, shortness of breath, chest tightness, and nasal congestion can occur due to an allergic reaction.
  • Gastrointestinal symptoms: Nausea, vomiting, diarrhea, and belly pain are possible gastrointestinal symptoms of a penicillin allergy.
  • Cardiovascular issues: A rapid heartbeat and decreased blood pressure can be signs of a severe allergic reaction.

Severe Reactions: Anaphylaxis

In rare cases, a penicillin allergy can lead to anaphylaxis, a life-threatening condition that requires immediate medical attention. Signs of anaphylaxis include:

  • Constriction of the airways: Difficulty breathing, wheezing, or a sensation of throat closure.
  • Rapid heartbeat and decreased blood pressure: A rapid heartbeat and low blood pressure can be signs of anaphylaxis.

Timing of Symptoms

Symptoms of a penicillin allergy can appear within minutes to several days after taking the medication. In some cases, delayed reactions can occur 1-2 weeks after exposure, manifesting as joint pain, rash, or fatigue.

References:

  • [1] Common symptoms of a penicillin allergy include skin rash or hives, itchy skin, coughing, nasal congestion, and swelling around the face, hands, and feet. (Source: #4)
  • [2] Anaphylaxis is a severe allergic reaction that can cause constriction of the airways, rapid heartbeat, and decreased blood pressure. (Source: #5)
  • [3] Symptoms of anaphylaxis include difficulty breathing, wheezing, or a sensation of throat closure. (Source: #9)

Additional Symptoms

Diagnostic Tests

Understanding Penicillin Allergy Diagnostic Tests

Penicillin allergy diagnostic tests are used to determine whether a person has an allergy to penicillin, which is a common antibiotic used to treat various bacterial infections. The tests aim to identify the presence of IgE antibodies in the blood or skin reaction to penicillin.

Types of Penicillin Allergy Diagnostic Tests

There are several types of diagnostic tests for penicillin allergy, including:

  • Skin Prick Test: This test involves pricking the skin with a small amount of penicillin and observing for a raised, itchy bump (wheal) within 15-20 minutes. A positive result indicates an allergy to penicillin.
  • Intradermal Test: Similar to the skin prick test, but a larger amount of penicillin is injected into the skin. This test is more sensitive than the skin prick test and can detect smaller amounts of IgE antibodies.
  • Blood Tests: Blood tests measure the levels of IgE antibodies in the blood. A positive result indicates an allergy to penicillin.

Procedure for Diagnostic Tests

The procedure for diagnostic tests typically involves:

  1. Skin Test: The skin is pricked or injected with a small amount of penicillin.
  2. Observation: The area is observed for 15-20 minutes to see if a raised, itchy bump (wheal) appears.
  3. Blood Test: A blood sample is taken to measure the levels of IgE antibodies.

Interpretation of Results

A positive result from any of these tests indicates an allergy to penicillin. However, a negative test result does not necessarily rule out an allergy, as some people may still experience symptoms even with low levels of IgE antibodies.

  • Positive Result: A raised, itchy bump (wheal) appears within 15-20 minutes, indicating an allergy to penicillin.
  • Negative Result: No reaction or a minimal reaction occurs, suggesting no allergy to penicillin.

References

[1] Mar 25, 2024 — The test is considered positive if an itchy, red bump at the site of the skin test appears in 15 to 20 minutes and negative if nothing happens. [3] In cases of a positive penicillin test, either the skin prick or intradermal test will produce a red, raised bump, signifying the presence of an allergy to the antibiotic. [6] A positive result means the patient is likely to have a penicillin allergy. If negative, a skin test is usually followed by an oral penicillin class challenge.

Note: The information provided above is based on the search results and may not be comprehensive or up-to-date. It's essential to consult with a healthcare professional for accurate diagnosis and treatment of penicillin allergy.

Additional Diagnostic Tests

  • Blood Tests
  • Skin Prick Test
  • Intradermal Test

Treatment

Treatment Options for Penicillin Allergy

Patients with no evidence of Type I allergy to penicillin may be treated with any cephalosporin or beta-lactam antibiotic for infections of any severity [1]. However, in most clinical settings, patients with reported penicillin allergy are precluded from treatment with such cephalosporin antibiotics as ceftriaxone [4].

Antihistamines and Corticosteroids

For mild to moderate penicillin allergy symptoms like itching and hives, antihistamines can provide relief. These medications come in various forms, including oral tablets, liquids, creams, and gels [3]. In some cases, corticosteroids may also be prescribed to help alleviate symptoms.

Desensitization

For individuals who are truly allergic to penicillin but require treatment with it or a closely related antibiotic, desensitization can be an option. This process involves gradually exposing the patient to increasing amounts of the allergenic substance until they become tolerant [6].

Alternative Antibiotics

In cases where patients are allergic to penicillin, alternative antibiotics such as clindamycin, azithromycin, and erythromycin may be used instead [8]. Other antibiotic classes like tetracyclines (e.g., doxycycline), macrolides (e.g., clarithromycin), aminoglycosides (e.g., gentamicin), and glycopeptides (e.g., vancomycin) can also be considered [9].

References

[1] Patients with no evidence of Type I allergy to penicillin may be treated with any cephalosporin or beta-lactam antibiotic for infections of any severity. [3] Antihistamines alleviate mild to moderate penicillin allergy symptoms like itching and hives. Forms include oral tablets, liquids, creams, and gels. [4] In most clinical settings, patients with reported penicillin allergy are precluded from treatment with such cephalosporin antibiotics as ceftriaxone. [6] Desensitization can be done for people who are truly allergic to penicillin but require treatment with it or a closely related antibiotic. [8] For those allergic to penicillin, which medication is used instead? Among common substitutes for penicillin include clindamycin, azithromycin, and erythromycin.

💊 Drug information is sourced from ChEBI (Chemical Entities of Biological Interest) database. Always consult with a healthcare professional before starting any medication. Click on any medication name for detailed information.

Differential Diagnosis

Differential Diagnosis of Penicillin Allergy

Penicillin allergy can be challenging to diagnose, and it's essential to consider other conditions that may present similarly. Here are some differential diagnoses for penicillin allergy:

  • Hypersensitivity reactions: These can include hemolytic anemia, toxic epidermal necrolysis (TEN), Steven's Johnson Syndrome (SJS), vasculitis, and interstitial nephritis [1].
  • Fixed drug eruption: This is a skin condition that occurs in response to certain medications, including penicillin. It can cause redness, swelling, and blistering on the skin [4].
  • Acute generalized exanthematous pustulosis (AGEP): This is a rare skin condition characterized by small pus-filled bumps on the skin, which can be triggered by penicillin or other medications [4].
  • Stevens-Johnson Syndrome (SJS) or toxic epidermal necrolysis (TEN): These are severe skin and mucous membrane disorders that can occur in response to certain medications, including penicillin. They require immediate medical attention [1], [4].

Diagnostic Procedures

When diagnosing penicillin allergy, the following procedures may be used:

  • Patient history: A thorough review of the patient's medical history is essential to determine if they have had a previous reaction to penicillin or other medications.
  • Laboratory diagnostics: Blood tests and skin testing can help confirm an allergic reaction [7].
  • Skin testing: This involves exposing the patient to small amounts of penicillin to see if they react. The most common method is the prick test, followed by a scratch test [10].

References

[1] Patterson, R. A., et al. (2023). Serious hypersensitivity reactions: A review of the literature.

[4] Solensky, R. (Cited by 1). Cutaneous manifestations of penicillin allergy.

[7] Wurpts, G. (2019). Diagnostic procedures in beta-lactam antibiotic allergy.

[10] Khan, D. A. (2022). Penicillin major determinant: Detects the greatest number of patients with IgE-mediated penicillin allergy through skin testing.

Additional Differential Diagnoses

  • cefuroxime allergy
  • Hypersensitivity reactions
  • Acute generalized exanthematous pustulosis (AGEP)
  • Fixed drug eruption
  • Stevens-Johnson Syndrome (SJS) or toxic epidermal necrolysis (TEN)

Additional Information

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