Case 1
A female with a history of environmental allergies, eczema, and obesity
was 11 years old at the time of her reaction. She sought care after an
episode of lip swelling, nasal congestion and throat discomfort
immediately after ingesting a Capri Sun® Pacific Cooler (pear, grape,
and orange juice concentrates, pineapple and apple juice). Symptoms were
treated at home with 50 mg of Benadryl, improved immediately, and
resolved completely within a week. Her exam was notable only for a blood
pressure of 138/62 and mild erythema of her oropharynx and nares. She
began a 5-day course of prednisone, was prescribed an epinephrine pen,
and was referred for further testing. Two weeks later she received skin
testing for apple, pineapple, grape, orange, pear, fresh orange, and
Capri Sun®, all of which tested negative. She had large positive skin
prick reactions to cat, mixed grass and one mold (Alternaria
alternata ), and tested positive to penicillin. An entire panel of
environmental allergens, including dog, dust mite, trees, and weeds,
tested negative, and she passed an oral pineapple challenge. It was
concluded that the patient had likely reacted to a mold contaminant in
the Capri Sun.