Chlorhexidine Anaphylaxis Masquerading as Septic Shock

International Archives of Allergy and Immunology

Volumn 167, Issue 1, 2015, Pages 16-20

  Hong, Choon Chiet ^a   Wang, Siew May ^a   Nather, Aziz ^a   Tan, Jiong Hao ^a   Tay, Sen Hee ^b   Poon, Keah How ^c  

^a NATIONAL UNIVERSITY OF SINGAPORE   (Singapore)

^b Department of University Medicine Cluster ^*  (Singapore)

^c NATIONAL UNIVERSITY HOSPITAL   (Singapore)

Author keywords

Adverse drug reaction; Anaphylactic shock; Chlorhexidine; Septic shock

Indexed keywords

C REACTIVE PROTEIN; CHLORHEXIDINE; CLINDAMYCIN; PENICILLIN DERIVATIVE; VANCOMYCIN; TOPICAL ANTIINFECTIVE AGENT;

ACUTE KIDNEY FAILURE; AGED; ANAPHYLAXIS; ARTICLE; BRONCHOSCOPY; CASE REPORT; CHILL; DEBRIDEMENT; DRUG HYPERSENSITIVITY; FASCIOTOMY; FEVER; HUMAN; HYPOTENSION; LABORATORY TEST; LEG PAIN; LEG SWELLING; LUNG LAVAGE; MALE; NECROTIZING FASCIITIS; NON ST SEGMENT ELEVATION MYOCARDIAL INFARCTION; PHYSICAL EXAMINATION; PLASTIC SURGERY; PRIORITY JOURNAL; SEPTIC SHOCK; SKIN REDNESS; SPLIT THICKNESS SKIN GRAFT; STREPTOCOCCUS DYSGALACTIAE; DERMATITIS, ALLERGIC CONTACT; IMMUNOLOGY; SKIN TEST; URTICARIA;

AGED; ANAPHYLAXIS; ANTI-INFECTIVE AGENTS, LOCAL; CHLORHEXIDINE; DERMATITIS, ALLERGIC CONTACT; HUMANS; MALE; SHOCK, SEPTIC; SKIN TESTS; URTICARIA;

EID: 84933526256     PISSN: 10182438     EISSN: 14230097     Source Type: Journal    
DOI: 10.1159/000431358     Document Type: Article

References (19)

1. Chopra V, Chopra H, Sharma A: Allergic urticaria: a case report of rare skin allergy with a common mouthwash. Indian J Dermatol 2013; 58:85.
2. Krautheim AB, Jermann TH, Bircher AJ: Chlorhexidine anaphylaxis: case report and review of the literature. Contact Dermatitis 2004; 50:U3-U116.
3. Darouiche RO, Wall MJ Jr, Itani KM, et al: Chlorhexidine-alcohol versus povidone-io-dine for surgical-site antisepsis. N Engl J Med 2010; 362:18-26.
4. Pratt RJ, Pellowe CM, Wilson JA et al: epic2: National evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. J Hosp Infect 2007; 65(suppl 1):S1-S64.
5. World Health Organization: Guidelines on hand hygiene in health care: a summary. Geneva, 2009. http://www.who.int/gpsc/5may/tools/who-guidelines handhygiene-summa-ry.pdf.
6. National Patient Safety Agency 'Clean Your Hands Campaign'. http://www.npsa.nhs.uk/cleanyourhands.
7. Toomey M: Preoperative chlorhexidine ana-phylaxis in a patient scheduled for coronary artery bypass graft: a case report. AANA J 2013; 81:209-214.
8. Bae YJ, Park CS, Lee JK, Jeong E, Kim TB, Cho YS, Moon HB: A case of anaphylaxis to chlorhexidine during digital rectal examination. J Korean Med Sci 2008; 23:526-528.
9. Noel J, Temple A, Laycock GJ: A case report of anaphylaxis to chlorhexidine during urinary catheterisation. Ann R Coll Surg Engl 2012; 94:e159-e160.
10. Guleri A, Kumar A, Morgan RJ, Hartley M, Roberts DH: Anaphylaxis to chlorhexidine-coated central venous catheters: a case series and review of the literature. Surg Infect (Larchmt) 2012; 13:171-174.
11. Beatty P, Kumar N, Ronald A: A complicated case of chlorhexidine-associated anaphylaxis. Anaesthesia 2011; 66:60-61.
12. Ebo DG, Bridts CH, Stevens WJ: Anaphylaxis to a urethral lubricant: chlorhexidine as the 'hidden' allergen. Acta Clin Belg 2004; 59: 358-360.
13. Jayathillake A, Mason DF, Broome K: Allergy to chlorhexidine gluconate in urethral gel: report of four cases and review of the literature. Urology 2003; 61:837.
14. Knight BA, Puy R, Douglass J, O'Hehir RE, Thien F: Chlorhexidine anaphylaxis: a case report and review of the literature. Intern Med J 2001; 31:436-437.
15. Wong CH, Khin LW, Heng KS, Tan KC, Low CO: The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections. Crit Care Med 2004; 32: 1535-1541.
16. Nagendran V, Wicking J, Ekbote A, Onyekwe T, Garvey LH: IgE-mediated chlorhexidine allergy: a new occupational hazard? Occup Med (Lond) 2009; 59:270-272.
17. Winrow MJ: Metabolic studies with radiola-belled chlorhexidine in animals and man. J Periodontal Res Suppl 1973; 12:45-48.
18. Kounis NG, Zavras GM: Histamine-induced coronary artery spasm: the concept of allergic angina. Br J Clin Pract 1991; 45:121-128.
19. Kounis NG: Kounis syndrome (allergic angina and allergic myocardial infarction): a natural paradigm? Int J Cardiol 2006; 110:7-14.