Allergic Reaction to a Latex Face Mask for Manual Ventilatory Support : A case report

ABSTRACT

The number of latex-induced allergic reactions, including anaphylaxis, has been increasing since latex induced contact urticaria was first reported in surgical patients by Nutter in 1979. Latex allergy is frequently seen in the healthcare industry, and is associated with systemic symptoms, hand eczema, and allergic contact dermatitis. Reactions range from contact urticaria, rhinitis and conjunctivitis, angioderma or bronchospasm to the recently recognized severe anaphylactic shock with cardiovascular collapse. We encountered a 55-year-old female patient who developed a severe anaphylactic reaction after manual vetilatory support using a facemask that contained latex. A subsequent allergy workup revealed a delayed-type hypersensitivity to latex. This case highlights the need for anesthesiologists to be able to diagnose the signs and symptoms of allergic reactions in patients during the peri-anesthetic period. Two types of allergic reactions to natural rubber latex (NRL) and rubber products are now known to exist type I (immediate-type) and type IV (delayed-type hypersensitivity [DTH]). Patients with NRL allergy should be provided with information on non-latex devices and latex avoidance in medical, dental, and occupational settings. In addition, we should pay more attention to the management of allergic reactions to latex in high risk groups.