Hypoxic-Ischemic Brain Damage Caused by Severe Anaphylactic Shock Following Intravenous Fluorescein Angiography at an Outpatient Clinic: A Case Report

Propose: To report a patient with hypoxic-ischemic brain damage caused by severe anaphylactic shock following intravenous fluorescein angiography at an outpatient clinic. Method: A case report. Result: A 52-year-old woman with macular hemorrhage was referred to our outpatient clinic for intravenous fluorescein angiography. The patient developed shortness of breath and syncope, followed by cardiopulmonary arrest one minute after injection of fluorescein. Under suspicion of fluorescein-related anaphylactic shock, immediate basic life support (BLS) and advanced cardiac life support (ACLS) were performed. Although the patient returned to spontaneous circulation after intensive resuscitation, she still suffered from severe hypoxic-ischemic brain damage and entered a persistent vegetative state. Conclusion: Although rare, potentially life-threatening anaphylactic shock following intravenous fluorescein angiography does occur. It is also difficult to predict before examination. When it happens, immediate medical treatment is crucial. An emergency care plan should be made and resuscitation medical equipment should be readily available.