Papain anaphylaxis: a case report.

We report a case which illustrates occupational sensitivity to Papain with life-threatening anaphylaxis. In addition to urticaria and angioedema and glottic symptoms, the patient demonstrated annoying intermittent problems mimicking rheumatoid, gastrointestinal, cardiac, and pulmonary disease. All symptoms and signs disappeared after he removed himself from direct occupational exposure to Papain, and he was able to continue working in a setting five stories removed from the powder. The ubiquitous presence of Papain in our daily lives, in the bathroom, dining room, hospital, or workplace establishes it as a significant contaminant. This case emphasizes the value of including papaya as a scratch testing antigen in clinical practice.