EC Paediatrics

A 12-year-old female child with known history of nasal allergy presented to emergency department after experiencing chest pain, difficulty in breathing and recordable blood pressure. Symptoms resolved with intramuscular epinephrine, oxygen support, nebulization with bronchodilator, intravenous corticosteroid and supportive treatment but later on presentation was complicated by recurrent hyperventilation, bronchospasm, chest pain and numbness in hands and feet. She was assessed by a multidisciplinary team and was found to be having rhinovirus/enterovirus infection to be main contributing factor. Anaphylaxis is a life-threatening hypersensitivity reaction that can present with respiratory compromise and cardiovascular collapse. Exercise is a recognized but uncommon trigger. Concurrent respiratory viral infections may further complicate the clinical picture by worsening bronchospasm and creating diagnostic uncertainty during recovery. On follow up visit she was found to be sensitized with house dust mite, a predisposing factor.

Keywords: Anaphylaxis; Adrenaline; Bronchospasm; Atopy; Emergency; Multiple Triggers; Viral Infection

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