By Day 3 of Week 1

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Strep Throat leading to allergic reaction from antibiotics

In the scenario provided, our patient presented with a sore throat, reddened posterior pharynx, and white exudate on tonsils. The patient was tested posted for strep by a rapid strep test. The patient was prescribed amoxicillin, and after the first dose, he immediately had swelling of his tongue and lips with trouble breathing and wheezing.

Genetics role

Certain people are predisposed to have allergies. If this is the case for type I allergies, it is called atopic. If our male patient’s mother or father has an allergy, then our patient has about a 40% chance of developing allergies. If both parents have allergies, then he has around an 80% chance of developing allergies. If our patient is atopic, he possibly produces higher amounts of IgE and could have more Fc receptors to IgE on his mast cells. This could make his airways and skin more responsive as well. Many genes are associated with this atopic state; polymorphisms in a large diversity of cytokines that manage IgE synthesis (McCance & Huether, 2018) Strep Throat NURS 6501 Discussion: Alterations in Cellular Processes.

What caused the symptoms

The patient possibly had a type I allergic hypersensitivity related to amoxicillin. Most of the symptoms of a type I reaction are due to the effects of histamine. The tissues that tend to be most affected contain a more significant number of mast cells and are more sensitive to histamine. The primary symptom being shortness of breath and wheezing could be because the throat was the main portal of entry for the allergen if it is the antibiotic. Effects of the allergy to the respiratory tract include vasodilation, inflammation, swelling, and edema of the larynx (McCance & Huether, 2018).

Physiologic response

Our patient had swelling of the tongue and lips with difficulty breathing and audible wheezes. The reaction to the medication caused an allergic reaction that produced a massive histamine response. This led to swelling, bronchoconstriction, and vasodilation. Since the cause of inflammation was due to histamine, it was an immediate response. The response led to vasodilation to increase capillary permeability, causing inflammation which led to trouble breathing and wheezing (David Woodruff, 2020) Strep Throat NURS 6501 Discussion: Alterations in Cellular Processes. Strep Throat NURS 6501 Discussion: Alterations in Cellular Processes

Cells involved

In the inflammatory response, there are many cells present. As the histamine enters the body, it causes vasodilation as the capillaries are dilated. The mast cells are activated by the allergen and release histamine. There are chemokines involved that act as messengers. Other cells involved could include phagocytes as the first responders, such as neutrophils. The body turns into a battlefield with everyone showing up, including B cells and T cells (Khan Academy, 2010).

Things that could change my response

If the kid’s genetics played a different factor, he might not be allergic to the antibiotic, and therefore there would be no allergic reaction. My genes have blessed me that, to my knowledge, I have no known drug allergies. I am also blessed to be able to eat peanut butter and shellfish. Our patient here may be atopic, making him predisposed to allergies with a more sensitive system.

References

David Woodruff. (2020, October 31). Acute Inflammation: The First Line of Defense. [Video]. YouTube. https://www.youtube.com/watch?v=mkKxBbKW97Q

Khan Academy. (2010, February 24). Inflammatory response | Human anatomy and physiology | Health & Medicine | Khan Academy [Video]. YouTube. https://www.youtube.com/watch?v=FXSuEIMrPQk

McCance, K. L., & Huether, S. E. (2018). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Mosby.

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