Was It Anaphylaxis? Will I need an Epi-pen?


Q: Hi, in work a couple of weeks ago, when say at my desk, I leant back and smelt the orange that the lady next to me was eating, now, for a few months the smell of oranges has taken my breath away and left me coughing as I am asthmatic, but now when I smelt it, my throat swelled up, I couldn't breathe, couldn't swallow, Los my voice, throat went dead dry and sore, a rash came on my cheeks that didn't go for a couple of days after, I staggered to the kitchen almost in a drunken state, collapsed over the counter, shaking and weak, feeling very faint and dizzy, I had that feeling you get when something happens that you are scared of- all hot, flustered and panicky and like full of doom, was sweating and delirious. This stayed like this for around half an hour but I didn't get sent to the hospital (I know!) I went the docs the next day who have referred me for an urgent appointment with the allergy clinic and I'm there on Monday, but I'm dreading that I could be anaphylactic, especially to such a wide spread smell.. A few days later I went to the loo and someone had sprayed an orangy like perfume, by the time I was back at my desk I had quite a bad asthma attack.. It's really scary and I feel more and more reluctant to go out incase I come across it. Do you think it was an anaphylactic shock? And if so why did it clear up on its own after a while? Do you think they will make me carry an epi pen? I feel almost desperate to have one now and see it as lucky that I have gotten this close to my appointment (25 days is urgent apparently!) without another attack.. Any help is greatly appreciated, thank you xxxx


A:   I do understand your concern. Although very rare, fragrances in nature have been found to cause exacerbation of symptoms and airway obstruction in asthmatic patients, including chest tightening and wheezing. Fragrance has be targeted as the most common cause of cosmetic allergic contact dermatitis. It is difficult for me to comment whether the episode you experienced is due to an anaphylactic attack or an exacerbation of acute asthmatic symptoms due to exposure of a particular fragrance, further investigation is required. If your symptoms were grave enough, definitely an epipen would be helpful in such a case.

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