• Jacob Adams, Jonathan Goc, Justin Zeien, Alpesh Patel, and Josephine Gambardella.
• Department of Anesthesiology, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA.
• Mil Med. 2023 Nov 3; 188 (11-12): e3699e3702e3699-e3702.

AbstractAnaphylaxis is an acute multisystem syndrome typically resulting from the sudden release of mast cell and basophil-derived mediators into the circulatory system. Isosulfan blue dye is a rare, but known, mediator of anaphylaxis with an incidence between 0.16% and 2% of cases. We report two cases of anaphylaxis attributed to the use of isosulfan blue dye in the intraoperative setting. Both of the patients we report had grade 3 anaphylactic reactions requiring vasopressors to correct significant hypotension. Both patients required overnight monitoring in the intensive care unit with the second patient also requiring continued vasopressor support.Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2023. This work is written by (a) US Government employee(s) and is in the public domain in the US.

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