Ischemic Stroke Secondary to Bleach Anaphylaxis

Abstract

Anaphylaxis is a severe allergic reaction characterized by life-threatening airway, breathing, and hemostatic problems. There has been an established association between cerebral infarction following wasp or bee sting in the literature. A 54-year-old female was admitted to the hospital for acute anaphylaxis due to bleach exposure and developed a new-onset left-sided weakness. Head computed tomography demonstrated midline frontal calcifications but was negative for acute ischemia or hemorrhage. Magnetic resonance imaging multifocal infarcts of the internal capsule’s right temporal and posterior limb. The patient was started on aspirin 81 mg, atorvastatin 40 mg daily for secondary prevention of stroke, and physical, occupational, and speech therapies. Although exceedingly rare, decreased cerebral blood flow may occur secondary to anaphylaxis due to an abrupt drop in blood pressure leading to ischemic injury. The case characterizes a unique association between bleach anaphylaxis and ischemic stroke, which has not been previously reported.