Cephalosporin antibacterial agents are widely prescribed for common infections or are administered as first-line prophylaxis for many types of surgical procedures. They may cause allergic reactions, especially IgE-mediated ones. The incidence of reactions to cephalosporins does not seem to be less than that to penicillins, but immediate hyper-sensitivity reactions to cephalosporins and the nature of their allergenic determinants are neither well studied nor fully understood by many clinicians. Anaphylactic reactions to cephalosporins can occur because of IgE-mediated reactions to the beta-lactam ring or side-chain structure,] which may be responsible for cross-reactivity among cephalosporins.] We report here a case of fatal anaphylaxis after intravenous cephalexin in a patient who had no history of penicillin allergy but who had been exposed to cefazolin 7 years earlier without any problems.
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