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Kiss and Tell

Usually, "kiss and tell" stories are just fuel for gossip. But not in this case...

An Italian lady showed up at a clinic complaining of generalized itching and swelling of her lips about 30 minutes after making love with her husband. The reaction resolved after treatment with cetirizine (Reactine), an antihistamine. Tests showed an absence of food allergies but a clue emerged when doctors learned that her husband had been recently diagnosed with gingivitis.

The suspicion now turned towards the possible transfer of some allergen during lovemaking. Kissing itself was unlikely to be the problem since one would assume that this activity occurred on numerous occasions without triggering the symptoms. This time, though, questioning revealed that the husband had taken an antibiotic, bacampicillin, about two hours earlier. The trace amounts of this compound that were transferred during kissing were enough to cause an allergic reaction. Physicians suspected the reaction after the 45-year-old woman revealed that four years earlier she had experienced similar symptoms after having been prescribed bacampicillin. At that time she had been successfully treated with cetirizine as well as with an intravenous injection of hydrocortisone, suggesting that she had experienced an allergic reaction.

In order to confirm the diagnosis, the husband was given either a placebo or bacampicillin on different days. Two hours after ingesting the sample he was asked to kiss his wife. Why two hours? Because that is roughly the length of time it takes for a drug to show up in salivary secretions. Just as had been suspected, the patient began to experience itching in the mouth and wheals on the face and arms about twenty minutes after kissing her husband on days when he had been taking the antibiotic. Symptoms disappeared within one hour after taking the antihistamine, cetirizine.

Why was the husband prescribed the antibiotic? Gingivitis is an inflammation of the gums which can be caused by the accumulation of bacteria. It is almost always the result of inadequate brushing and flossing that allows plaque to remain along the gum line. Plaque is the soft, sticky film made up primarily of bacteria that accumulates on teeth and hardens into tartar. Gingivitis is not only a danger to the teeth but to the heart as well. Bleeding gums can allow bacteria to enter the bloodstream and provoke inflammation in the coronary arteries which can lead to heart disease. “Kiss and tell” usually causes a problem, but in this case, it solved one.


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