title: [Anaphylactic shock associated with a central venous catheter impregnated with chlorhexidine and silver sulfadiazine].
abstract: A 28 year-old male patient developed anaphylactic shock on separate occasions, possibly due to the contact with a central venous catheter impregnated with chlorhexidine and silver sulfadiazine. He was successfully resuscitated. On the second operation, blood basophils disappeared and plasma histamine level increased extremely up to 80 ng.ml-1 soon after anaphylactic shock. One year after the first shock, he did not develop anaphylactic shock following the insertion of a central venous catheter without the impregnation. Pin prick test and scratch test showed positive reactions only to chlorhexidine. Latex-specific anti-IgE antibody was not detected. Therefore, chlorhexidine was confirmed as the causative agent of anaphylactic shock. Because chlorhexidine is extensively used as an antiseptic drug in emergency rooms and intensive care units, we should be aware of the possibility of chlorhexidine induced anaphylactic reactions.
authors.affiliation: Department of Anesthesiology, Gifu Prefectural Hospital.
authors.forename: E
authors.initials: E
authors.lastname: Terazawa
authors.forename: K
authors.initials: K
authors.lastname: Nagase
authors.forename: T
authors.initials: T
authors.lastname: Masue
authors.forename: Y
authors.initials: Y
authors.lastname: Niwa
authors.forename: I
authors.initials: I
authors.lastname: Fukao
authors.forename: H
authors.initials: H
authors.lastname: Shimonaka
authors.forename: T
authors.initials: T
authors.lastname: Yokoi
authors.forename: N
authors.initials: N
authors.lastname: Kondoh
authors.forename: S
authors.initials: S
authors.lastname: Dohi
mesh_terms: D000328:Adult; D000707:Anaphylaxis / Q000139:chemically induced*; D000891:Anti-Infective Agents, Local / Q000009:adverse effects*; D002405:Catheterization, Central Venous; D002710:Chlorhexidine / Q000009:adverse effects*; D006801:Humans; D008297:Male; D012837:Silver Sulfadiazine / Q000009:adverse effects*
chemical_list: D000891:Anti-Infective Agents, Local; D002710:Chlorhexidine; D012837:Silver Sulfadiazine