Anaphylactic Shock in General Internal Medicine Practice: Current Diagnostic Challenges and Emergency Management Strategies

anaphylaxis anaphylactic shock internal medicine epinephrine emergency algorithm biphasic reaction

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February 22, 2026

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Anaphylactic shock remains a rapidly progressive and potentially fatal  emergency, with increasing incidence worldwide. Despite the availability of international guidelines, mortality persists due to delayed recognition and underuse of epinephrine. Importantly, a significant proportion of first medical contacts occur in outpatient and internal medicine settings rather than emergency departments. This review aims to analyze current evidence regarding epidemiology, pathophysiology, clinical heterogeneity, diagnostic pitfalls, and emergency management strategies of anaphylactic shock, with a specific focus on challenges faced by general internists. The gap between guideline recommendations and real-world clinical behavior is critically discussed.

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