Subjective
Date of visit
Reason for visit (evaluation for suspected pollen-food allergy syndrome, follow-up for diagnosed syndrome)
History of present illness:
Symptoms suggestive of pollen-food allergy syndrome (occurring shortly after ingesting certain raw fruits, vegetables, or nuts):
Oral itching or tingling
Swelling of the lips, tongue, or throat
Throat tightness
Nausea, vomiting (less common)
Specific foods triggering symptoms (if identified)
Seasonal variations in symptoms (may correlate with pollen seasons)
Past medical history of allergies (hay fever, eczema)
Medications (current medications)
Allergies (other known allergies)
Objective
Vital signs (temperature, heart rate, blood pressure) – usually normal unless severe reaction
Physical exam (limited if no active symptoms):
Oropharyngeal exam (looking for swelling of the lips, tongue, or uvula)
Assessment
Suspected pollen-food allergy syndrome based on history and clinical presentation
Consideration of alternative diagnoses (food allergies not related to pollen)
Plan
Diagnostic workup (may include some of the following, depending on severity):
Skin prick testing with common pollen and food allergens
Specific IgE blood tests (less specific than skin prick testing)
Oral food challenge (performed by an allergist in a controlled setting)
Management:
Education on identifying and avoiding trigger foods
Dietary modifications (may involve elimination of specific foods or peeling/cooking to reduce allergenicity)
Antihistamines (to be taken prophylactically before potential exposure or to treat mild symptoms)
Epinephrine auto-injector prescription (for severe reactions – only if a risk is identified)
Education
Explain pollen-food allergy syndrome, the link between pollen and certain foods, and the importance of identifying trigger foods.
Discuss dietary modifications and safe food choices.
Proper use of an epinephrine auto-injector (if prescribed).
Importance of seeking immediate medical attention for severe allergic reactions (anaphylaxis).
Follow-up
Schedule for follow-up appointments:
Discuss results of diagnostic testing and refine management plan
Review adherence to dietary modifications and symptom control
Consider referral to an allergist for complex cases or severe reactions
Disclaimer: This information is for educational purposes only and should not be interpreted as medical advice. Please consult with a qualified healthcare professional for diagnosis and management of pollen-food allergy syndrome.