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The causal allergen was not identified until a further severe anaphylactic reaction occurred after oral use of cefuroxime during a respiratory infection. Sensitization to cefuroxime was demonstrated by specific IgE, basophil activation test and skin prick test. An inhalation challenge with a dosimeter induced generalized urticaria after a cumulative dose of about 10\u2009\u03bcg of the drug, but no asthmatic reaction. Complete exposure cessation was initiated and a 1\u2010year follow\u2010up was without further allergic reactions. We conclude that work\u2010related systemic allergic reactions to \u03b2\u2010lactam antibiotics may occur in nurses after inhalation of low doses and without perceived association with drug\u2010specific tasks like handling of antibiotics.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ajim.22788","type":"journal-article","created":{"date-parts":[[2017,11,8]],"date-time":"2017-11-08T08:45:54Z","timestamp":1510130754000},"page":"261-266","source":"Crossref","is-referenced-by-count":8,"title":["Occupational generalized urticaria and anaphylaxis after inhalation of cefuroxime in a nurse"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0580-7597","authenticated-orcid":false,"given":"Rolf","family":"Merget","sequence":"first","affiliation":[{"name":"Institute for Prevention and Occupational Medicine of the German Social Accident Insurance Institute of the Ruhr University Bochum (IPA) Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Sander","sequence":"additional","affiliation":[{"name":"Institute for Prevention and Occupational Medicine of the German Social Accident Insurance Institute of the Ruhr University Bochum (IPA) Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manig\u00e9","family":"Fartasch","sequence":"additional","affiliation":[{"name":"Institute for Prevention and Occupational Medicine of the German Social Accident Insurance Institute of the Ruhr University Bochum (IPA) Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"van Kampen","sequence":"additional","affiliation":[{"name":"Institute for Prevention and Occupational Medicine of the German Social Accident Insurance Institute of the Ruhr University Bochum (IPA) Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefani","family":"R\u00f6seler","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology University Hospital Aachen Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Merk","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology University Hospital Aachen Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerda","family":"Wurpts","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology University Hospital Aachen Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Raulf","sequence":"additional","affiliation":[{"name":"Institute for Prevention and Occupational Medicine of the German Social Accident Insurance Institute of the Ruhr University Bochum (IPA) Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Br\u00fcning","sequence":"additional","affiliation":[{"name":"Institute for Prevention and Occupational Medicine of the German Social Accident Insurance Institute of the Ruhr University Bochum (IPA) Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,11,8]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra993637"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.95.08081421"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-3003.1999.13e40.x"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2009.02062.x"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1967.03120140133035"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.1994.tb02711.x"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.1994.tb00208.x"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2009.02229.x"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.05.00034805"},{"key":"e_1_2_11_11_1","unstructured":"Merget R Heinze E Neumann L Taeger D Br\u00fcning T. 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