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Timothy Nguyen, DO. Maria Fernanda Villavicencio, MD. Tiffany Schwasinger-Schmidt, MD., PhD. Neha Patel, MD.
Department of Internal Medicine, KU School of Medicine, The Center for Allergy & Immunology - Kansas City Physician Partners
ABSTRACT:
A 37-year-old female with intermittent asthma and allergic reactions to certain foods, cefaclor, Tdap vaccine and first dose of Pfizer COVID-19 vaccine, presented to the ER with hives, pruritus and syncope immediately after the second COVID-19 Pfizer vaccine. She was successfully stabilized after 72-hours on an epinephrine drip. One week after, she was admitted to the ICU for a month-long stay for persistent anaphylactic-like symptoms of neck soft-tissue swelling, stridor, dyspnea, urticaria, and tachycardia. Diagnostic testing showed low tryptase and normal complement levels and no vocal cord dysfunction on laryngoscopy. She was treated with epinephrine, antihistamines, high-dose steroids, omalizumab and montelukast. Over the next six months since her ICU discharge, she has had four hospitalizations due to complications with throat-swelling, dyspnea, pneumonia, and a central line infection. As of today, she continues to have persistent angioedema, stridor and urticaria that is treated with antihistamines, omalizumab, tacrolimus, and intermittent steroids.
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