Case report: Intraoperative anaphylaxis secondary to latex allergy revealed after subsequent reaction to peach

Abstract

Rationale To report a patient who experienced two episodes of unexplained intraoperative anaphylaxis. Diagnosis of latex allergy was made when the patient experienced a third episode of anaphylaxis after eating a peach. Methods Allergy skin tests were performed with latex glove and sap extract along with several cross-reactive foods, including peach. Peach allergy was assessed with both fresh fruit prick-prick testing and a commercial peach extract. Results Skin prick tests showed a positive reaction at a dilution of 1/100 for both latex glove and sap extract. The skin test using a commercial peach extract was negative, but a fresh peach prick-prick test was positive. Skin testing for various cross-reactive foods showed a positive reaction to fresh plum, papaya, tomato, and commercial almond extract while negative reactions were noted for fresh banana, kiwi, and avocado. Negative reactions were also noted for commercial extracts of cantaloupe, cacao, and grape. Conclusions Latex allergy should be considered in all cases of unexplained intraoperative anaphylaxis. Classic risk factors for latex allergy are not always present and the presence of food cross-sensitization difficult to predict. This patient adds to the growing number of cases where patients with latex allergy may also react to members of the stone fruit family, specifically, peach.