Oral allergy syndrome after ingestion of salami in a subject with monosensitization to mite allergens

Abstract

The bulk of reports of side chain-specific [Mactam allergy have emanated from Spain and involve the aminopenicillins, ampicillin and amoxicillin. 3, 4 Fewer reports relate to cephalosporins, and a literature search revealed only one such report from North America. 5 Interestingly, this report was of four cases of anaphylaxis to intravenous cefazolin given before surgery. A number of conclusions can be drawn from this report: (1) side chain-specific cefazolin allergy appears to be uncommon (0.1% or less); (2) the incidence of false-positive intradermal cefazolin skin test results (1 mg/ml) is low; (3) a positive cefazolin skin test response, especially in conjunction with a history of a clinical reaction to cefazolin, should be considered highly clinically significant; and (4) an isolated positive cefazolin skin test response warrants additional skin testing and oral or parenteral challenge testing to identify side chain-specific allergy with good tolerance to other 6-1actams.