Military implications of atropine hypersensitivity

Atropine hypersensitivity is a rarely reported condition. However, in the military environment, such reactions are of significant concern given the threat of chemical warfare and the use of atropine as a nerve agent antidote. Upon deployment to regions where chemical attacks are a threat, each service member is issued three 2-mg intramuscular autoinjectors of atropine for self-treatment. In the case presented here, an active duty service member presented to his Aid Station to request red dog tags for a previously identified allergy to atropine. Sensitivity testing revealed a significant reaction to < 0.03 mg of intradermal atropine. This rarely reported reaction, in the military environment, poses a unique question regarding the suitability of deploying military members to areas where exposure to chemical warfare agents is possible.