The patient is most likely suffering from anaphylaxis. Anaphylaxis is a severe allergic reaction that occurs when an individual is exposed to something that they are allergic to. ( McCance et al, 2019) . These reactions occur almost immediately after exposure to the offending agent. In this scenario, it seems that the boy is allergic to the amoxill that the doctor prescribed for his condition. The severe allergic condition contributed to the severe symptoms seen such as difficulty in breathing and wheezing.
Anaphylaxis is mediated by a group of cells known as mast cells. When the body is exposed to a substance it is allergic to, mast cells get activated and release large amounts of histamine and leukotrienes which then trigger a massive inflammatory reaction ( McCance et al, 2019) . The effect of this severe inflammatory reaction is hypotension and shock, laryngeal edema which obstructs the airway making it for the patient to breath. These allergic reactions are mediated by IGE antibodies ( Justiz-Vaillant et al, 2019) . Mast cells in the respiratory system, in the gut, in the skin and in the perivascular spaces are all involved during anaphylaxis. In the case of the patient in this case study, the severe inflammatory reaction as a result of exposure to amoxicillin caused a massive inflammatory reaction which resulted in laryngeal edema as a result of fluid extravasation with subsequent airway narrowing that caused the observed difficulty in breathing and a wheeze.
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There is a strong genetic link between allergic reactions and the genetic make-up of an individual. The evidence of this is the fact that patients who exhibit allergic reactions have a familial association which proves that the genetic makeup of an individual is crucial in the occurrence of such reactions ( McCance et al, 2019) . Research has established that in patients who experience allergic reactions have an upregulation of the genes that modulate inflammation and what this means is that during an allergic reaction, people who are allergic to any particular substance have an over expression of the genes that mediate inflammation and this leads to over production of inflammatory cytokines which means that the inflammatory reaction that will be observed will be more explosive than normal and this is what contributes to the severe symptoms observed. This implies that allergic reactions are hereditary and hence can be passed from one generation to another. In this case, the boy is allergic to amoxicillin and the moment the body was exposed to amoxicillin, there was an upregulation of the genes that mediate allergic reaction and this lead to severe inflammatory reaction which caused airway edema causing airway obstruction and shortness of breath.
Such allergic reactions are also affected by the gender of the affected person. Research has shown that women are more susceptible to allergic reactions as compared to males. It has also been observed that allergic reactions in females also last longer and have worst outcomes as compared to male subjects. In view of the case study, it would be prudent to say that the outcome would have been worse if at all it is a female who was affected. Environmental factors such as the season, the concentration of the allergen in the environment also affect the development of the allergic reactions. For example, allergies such as allergic rhinitis get worse during the season when molds are releasing spores.
In summary, anaphylaxis reactions are severe type I allergic reactions that occur after an individual is exposed to a substance that they are exposed to. These reactions appear within minutes after exposure and hence they are classified as type I. These reactions are usually life threatening in nature and require urgent attention to avert mortality. Patients can be allergic to a variety of products but in our case study, the drug that the patient was given was the offending agent. Other factors that affect the severity of these allergies include the concentration of the allergen in the environment, the sex of the individual as well as the season. The bottom line with anaphylactic reactions is that they must be treated as an emergency since delays in management lead to poor prognosis.
References
Justiz-Vaillant, A. A., & Zito, P. M. (2019). Immediate hypersensitivity reactions. In StatPearls. Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513315/
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
