6
Diagnosis
Table 2. Signs and Symptoms of Anaphylaxis
System Symptoms
Skin Flushing (local or generalized), localized itching of skin or
mucosa (local areas – eg, palms, genitalia, and/or palate)
or generalized itching, urticaria, angioedema of skin or
mucosa (eg, lips or tongue), morbilliform rash, pilar erection,
conjunctival itching, redness, tearing, and/or swelling
Cardiovascular Chest pain (eg, substernal), tachycardia, bradycardia,
palpitations, arrhythmias, hypotension, feeling faint, shock,
cardiac arrest, urinary or fecal incontinence
Respiratory Nasal itching, congestion, rhinorrhea, sneezing, throat itching
and tightness, dysphonia, hoarseness, stridor, coughing,
shortness of breath, increased respiratory rate, wheezing, chest
tightness, cyanosis, respiratory arrest
Gastrointestinal Abdominal pain (eg, cramping ), nausea, vomiting, diarrhea,
dysphagia
Central nervous
system
Aura of impending doom, uneasiness, sudden behavioral
change (eg, irritability), dizziness, headache (eg, throbbing ),
altered mental state, tunnel vision, confusion, seizure
Other Metallic taste in mouth, uterine cramping and/or bleeding
Table 3. Essential Features of History in the Evaluation
of a Patient Who Has Experienced an Episode of
Anaphylaxis
Detailed history of ingestants (foods/drugs) taken within 6 h before the event
Activity in which the patient was engaged at the time of the event
Location of the event (home, school, work, indoors/outdoors)
Exposure to heat or cold
Any related sting or bite
Time of day or night
Duration of event
Recurrence of symptoms aer initial resolution
Exact nature of symptoms (eg, if cutaneous, determine whether flush, pruritus, urticaria,
or angioedema)
In a woman, the relation between the event and her menstrual cycle
Was medical care given and what treatments were administered
How long before recovery occurred and was there a recurrence of symptoms aer a
symptom-free period
