Approach

Diagnosis is almost always based on history, physical examination, and clinical judgement. The first step is discerning whether the reaction is severe (life-threatening anaphylaxis/anaphylactoid reactions). Any suspicion of anaphylaxis should prompt immediate action. Less severe reactions can be treated with comforting measures. Little, if any, formal testing is helpful in acute encounters; often, definitive diagnosis is not achievable acutely.

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