Peanut Allergy Saves a Patient with Cold-Induced Hypotension and Urticaria

An 11-year-old girl with an allergy to peanuts had lightheadedness 15 minutes after she started swimming in the ocean. Friends noticed urticarial lesions on her legs and arms. She fainted within seconds after walking to the shoreline. Emergency personnel measured the child's blood pressure at 50/20 within 15 minutes after the reaction began. Because they thought she had ingested peanuts accidentally, she was sprayed with cold water to wash off any possible allergens. With continued hypotension and persistence of urticaria, she was given an injection of epinephrine. Immediately her blood pressure improved and the urticarial lesions resolved within minutes.