Anaphylactic Shock Case with Massive Hemoptysis after the First Dose of Ceftriaxone

Our case was a 29-year-old male patient who applied to the urology clinic in our hospital because of high fever and testicular pain. As a result of the tests performed, the patient was hospitalized with the diagnosis of orchitis. In the patient who received iv 1gr ceftriaxone for treatment, wheezing, redness in the body, hemoptysis and fainting developed. After that the patient was admitted to the intensive care unit. The patient’s blood pressure was 80-50 mmhg, saturation%65 and respiratory rate 50/min. In the first hour, the patient spit a total of approximately 300cc blood. Intravenous adrenalin was applied with the findings of anaphylactic shock. In addition to the treatment, dexamethasone, tranexamic acid and pheniramine were administered. The patient’s vital signs were improved after the treatment, and the thorax was taken. In both lung parenchyma, opacities were observed in widespread, rounded iced glass density supporting alveolar hemorrhage secondary to anaphylaxis. The treatment of the patient was continued with IV Ciprofloxacin. Hemoptysis was reduced in the following days. On the control chest X-ray, nodular opacitive lesions disappeared completely. In the literature, there are case reports indicating the occurrence of anaphylaxis after the first dose of ceftriaxone treatment. But as our case with massive haemoptysis was not reported. Our aim to present this case is to remind that anaphylaxis and anaphylactic shock may occur even in the first doses of cephalosporin group drugs, such as ceftriaxone, which is frequently used nowadays.