Anaphylaxis is a serious side effect experienced by mainly anaesthetists as compare to other physicians. Owing to simultaneous administration of many drugs in perioperative period, causality assessment of drug causing the adverse reactions is usually difficult. Here, were present a rare case of a propofol induced hypersensitivity reaction in a young lady who was posted for a robotic cystectomy under general anaesthesia for ovarian cyst. She was given Propofol in perioperative period along with other anaesthetics. She developed hypotension, tachycardia and facial flushing, angioedema and urticaria over forearms. The causal agent of this adverse event was confirmed by measurement of mast cell tryptase, multiple skin patch test and intradermal sensitivity test. Patch and intradermal sensitivity test were negative for all the drugs used in perioperative period except propofol. Clinical features, investigation and causality assessment suggest Propofol to be the causative drug for anaphylactic reaction. All patients with a suspected anaphylactic reaction during anaesthesia should be investigated to determine the allergic nature of the reaction and to identify the responsible drug.

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A 73 years old male, known hypertensive on medication, with the history of SARS-CoV-2 infection nine months ago, presented to us with mucormycosis, he was treated with Liposomal amphotericin B initially. He developed acute kidney injury with recurrent pulmonary oedema requiring ICU admission and Haemodialysis. He later developed catheter related blood stream infection that grew Carbapenem resistant Klebsiella pneumonia and was started on Polymyxin B. However from day 3 of antibiotics he started to develop recurrent respiratory arrest with no apparent cause. He required a brief period of mechanical ventilation and was successfully weaned. He had recurrent such episodes with no apparent cause. After extensive work up and literature search it was diagnosed as Polymyxin B induced respiratory failure. Polymyxins were stopped, patient was discharged in a stable condition after five days of further observation and is currently on follow up with no such episode of dyspnoea.