When working with Urticaria, it’s important to dig deeper into the root cause. Understanding why a person has urticaria may help shape our treatment philosophy. One possible factor is infection.

Role of Infections in Spontaneous Acute Urticaria

Acute Urticaria is the case where symptoms lasts less than 6 weeks. Acute urticaria is a classic presentation of viral infections in kids. It’s also relatively common in adults too. About 35% of acute urticaria in adults are caused by viral infections, while 57% of cases in kids is caused by viral infection.

Overall, various infectious agents are implicated in acute urticaria, including streptococcus, mycoplasma, parvovirus B19, Norovirus, enterovirus, Hepatitis A or B, plasmodium falciparum [3].

Seasonality of urticaria is also explained by peaks of infection of influenzas, adenovirus and respiratory syncytial and parainfluenza and rhinoviruses in the winter months and coxsackie and corona viruses in the summer months [3].

Role of Infections in Spontaneous Chronic Urticaria

Chronic urticaria are those cases where symptoms last beyond 6 weeks. Research is mixed, but there are many reports and research papers that demonstrate improved urticarial symptoms after clearing of infections. Most reported infections in chronic urticaria are related to gastrointestinal tract, followed by Dental and ear, nose and throat regions.

One of the most prevalent infectious agents resulting in chronic urticaria is Helicobacter pylori (H. pylori) infection. Some research goes as far as recommending routine screening for H. pylori in those with chronic urticaria [3]. In some research remission rate of urticaria was 61.5% when H. Pylori was eradicated versus 33.6% when H. Pylori was not eradicated.

Other common infections found in cases of chronic urticaria are Bacteria (Yersinia, Streptrococci, Staphylococci, Mycoplasma pneumoniae), Viruses (Norovirus, Hepatitis A and B) , Parvovirus) and parasites (trichinella, trichomonas vaginalis, toxocaracanis, Anisakis simplex, Giardia lamblia, entamoeba sp.) [3].

Dental and Ear/Nose/Throat infections are also sometimes implicated with chronic urticaria. Some research found sinusitis in 32% of patients with Chronic urticaria, and dental focal infections in 29% of patients. On that trial at least 8 cases resulted incomplete remission of chronic urticaria after elimination of dental infections. Systemic antibiotic treatments of dental or focal infections can sometimes help alleviate symtoms of hives and urticaria. 

Review

Chronic urticaria can be triggered by and caused by many factors, of which one is previous infection. Specific bacterial agents have been identified as having a key role to play. Eradicating these infections can be helpful. Working with a Naturopath or doctor experienced in these aspects of hives may be helpful.