Anaphylaxis to Polysporin® ointment in a pediatric patient

Case report A 13 year old male rubbed a white eraser against the dorsum of his hand at school and the skin became abraded with some open areas of broken skin. He applied Polysporin ointment (polymyxin B sulfate and bacitracin) to the area after he arrived home. Within 15 minutes he developed urticaria on his back, legs and arms. His eyes became very itchy and he developed marked angioedema of his eyelids with urticaria around his eyes. He developed difficulty breathing and described a tight feeling in his chest. He took diphenhydramine and salbutamol via MDI. He did not go to the Emergency Department. His symptoms gradually resolved after approximately two hours. Previous use of Polysporin in the past did not cause any difficulties. Epicutaneous testing was positive to a 1 in 10 dilution of Polysporin ointment. Testing was negative to latex. Further testing to the specific components, polymyxin B sulfate and bacitracin is pending.