Abstract

Background: Chronic spontaneous urticaria (CSU) is a condition characterised by the presence of hives with/without angioedema, that affects individuals on more days than not for 6 weeks or more. The role of infection as a potential trigger for CSU is well described, but the current clinical guidelines do not recommend routine screening for underlying infections. Main observations: We report a case of severe prolonged chronic spontaneous urticaria in a 19-year-old, that went into rapid remission following the treatment of dental infection. Conclusions: Clinicians should recognise the potential role that infection can have in causing chronic urticaria. There should be a low threshold to treat infection in such circumstances.

Highlights

  • Urticaria is a dermatological disorder that manifests as raised erythematous lesions that range in size

  • Urticarial lesions may be associated with episodes of swellings known as ‘angioedema’

  • We report a case of severe chronic spontaneous urticaria that rapidly resolved following root canal treatment

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Summary

Introduction

Urticaria is a dermatological disorder that manifests as raised erythematous lesions that range in size. Case report A 19-year-old male patient was referred to the Immunology clinic by his General Practitioner He presented with a two-month history of urticaria with intermittent episodes of angioedema. The following day, he experienced a recurrence of the symptoms and continued to have almost daily symptoms of urticaria with intermittent episodes of angioedema He was commenced on an alternative anti-histamine by his GP but continued to develop urticaria and experience swellings of the hands and feet. His treatment was escalated at his initial visit to Immunology Clinic to fexofenadine 180mg twice a day with an additional 10–20mg of cetirizine. Initial investigations including full blood count, renal function, liver function and thyroid function tests were all within the normal ranges

Discussion
Monroe EW
Findings
Tanphaichitr K
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