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Anaphylaxis to stinging insect with myocardial infarction
Abstracts S75
struction site by a single wasp in the right nuchal region with swelling of both lips within the hour. He was transported to the ER and was unconscious on arrival. He was intubated within 2 hours of presentation and admitted to the ICU after he was given Epi nephrine 0.3 cc 1/1000 subcutaneously and then a second dose down the endotracheal tube. He was given Benadryl 100mg q6h and Decadron 24mg initially then 8mg q8hIVas well as O2 assistance. Labsy) His EKG within 21/2 post admission demonstrated ST/T wave changes consistent with anterior lateral septal wall myocardial infarction with nonspecific ST-T wave changes. He had an ECHO consistent with hypokinesis and anterior/lateral wall septal infarction confirmed by cardiology. His CPK was initially 149u/l (elevated)on the day of admission within 2 hours it was 212u/l with MBSC initially 1.2nanograms/ml on admission then 6.8nanograms/ml within 2hours post admission. Troponin I was undetectable on admission then 11.4 nanograms/ml within 2 hours. He was discharged after 48hours with a normal physical exam. RAST IgE to yellow jacket from one day post admission was 4.41 KU/L (3.5-17.5KU/L antibody level high by QuestDiagnostics Wallingford, CT) class 3, white faced hornet 3.34ku/l (class2), yellow faced hornet 5.48ku/l(class3), paper wasp 2.27ku/l (class2). CONCLUSION: We have presented a case of venom anaphylaxis with myocardial infarction. Funding: Self-funded
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Anaphylaxis to Stinging Insect With Myocardial Infarction: A Case Report
C. C. Randolph; Allergy, Yale/Waterbury Affiliate, Waterbury, CT. RATIONALE: Anaphylaxis to Hymenoptera venom with associated coronary vasospasm and infarction has been reported rarely. METHOD: Case Report: We present a previously healthy 25 year old black male painter who developed myocardial infarction following alleged sting to the right neck area. RESULTS: On the day of admission he was stung while painting at a con-
SATURDAY
J ALLERGY CLIN IMMUNOL VOLUME 113, NUMBER 2
struction site by a single wasp in the right nuchal region with swelling of both lips within the hour. He was transported to the ER and was unconscious on arrival. He was intubated within 2 hours of presentation and admitted to the ICU after he was given Epi nephrine 0.3 cc 1/1000 subcutaneously and then a second dose down the endotracheal tube. He was given Benadryl 100mg q6h and Decadron 24mg initially then 8mg q8hIVas well as O2 assistance. Labsy) His EKG within 21/2 post admission demonstrated ST/T wave changes consistent with anterior lateral septal wall myocardial infarction with nonspecific ST-T wave changes. He had an ECHO consistent with hypokinesis and anterior/lateral wall septal infarction confirmed by cardiology. His CPK was initially 149u/l (elevated)on the day of admission within 2 hours it was 212u/l with MBSC initially 1.2nanograms/ml on admission then 6.8nanograms/ml within 2hours post admission. Troponin I was undetectable on admission then 11.4 nanograms/ml within 2 hours. He was discharged after 48hours with a normal physical exam. RAST IgE to yellow jacket from one day post admission was 4.41 KU/L (3.5-17.5KU/L antibody level high by QuestDiagnostics Wallingford, CT) class 3, white faced hornet 3.34ku/l (class2), yellow faced hornet 5.48ku/l(class3), paper wasp 2.27ku/l (class2). CONCLUSION: We have presented a case of venom anaphylaxis with myocardial infarction. Funding: Self-funded
201
Anaphylaxis to Stinging Insect With Myocardial Infarction: A Case Report
C. C. Randolph; Allergy, Yale/Waterbury Affiliate, Waterbury, CT. RATIONALE: Anaphylaxis to Hymenoptera venom with associated coronary vasospasm and infarction has been reported rarely. METHOD: Case Report: We present a previously healthy 25 year old black male painter who developed myocardial infarction following alleged sting to the right neck area. RESULTS: On the day of admission he was stung while painting at a con-
SATURDAY
J ALLERGY CLIN IMMUNOL VOLUME 113, NUMBER 2