A 4-month-old baby boy presenting with anaphylaxis to a banana: a case report

INTRODUCTION: Food allergy is the most common cause of anaphylaxis in children and recent studies suggest increased prevalence of both food allergy and anaphylaxis. Among foods, fruits are rarely implicated as the cause of anaphylaxis. Furthermore, anaphylaxis to fruit in the first months of life is rare. Although banana allergy has been well described in adults, there are only two case reports of anaphylaxis to banana in children. CASE PRESENTATION: A 4-month-old Hispanic baby boy with a history of eczema presented to our emergency room with vomiting, urticaria and cyanosis following first exposure to a banana. He improved with administration of intramuscular epinephrine. Skin prick tests showed positive results for both fresh banana (4mm wheal/15mm erythema) and banana extract (8mm wheal/20mm erythema). CONCLUSIONS: Banana is not considered a highly allergenic food. However, as food allergy becomes more common and solid foods are being introduced earlier in babies, banana may become an important allergen to consider in cases of babies presenting with anaphylaxis.