1) Another anaphylactic shock. She came to the ED within 15 minutes of eating pizza with a “lump” in her throat and tightness in her lips. she got .5mg of subQ epi STAT and felt much, much better.

2) A man who developed a rash to his antibiotic after nasal reconstruction surgery for a deviated septum was told by his surgeon to come to the ED if he developed trouble breathing, being concerned about an anaphylacitc reaction like the lady above. He came to my ED at 2 AM. OUr dialogue went like this:

“Are you having trouble breathing?” I asked.

“What do you mean,” he asked back.

“Is it difficult to get enough air?” I restated.

“Well, I can’t breath through my nose,” he said.

You do the math…

3) Toxic Shock Syndrome in a preteen due to a superinfected poison ivy!