Bahal Sameer, Sharma Samriti, Garvey Lene Heise, Nagendran Vasantha
Department of Immunology, Barts Health NHS Trust, London, UK.
Critical Care Department, University College London Hospitals NHS Foundation Trust, London, UK.
BMJ Case Rep. 2017 Aug 8;2017:bcr-2017-219794. doi: 10.1136/bcr-2017-219794.
A 54-year-old man with end-stage renal failure attended for dialysis. Within seconds of applying 2% w/v chlorhexidine (ChloraPrep 3 mL Wand Applicator) to the skin surrounding the insertion point of his dialysis catheter (Tesio catheter), he developed pruritus, urticaria, shortness of breath, hypotension and reduced responsiveness. Treatment for anaphylaxis was initiated with rapid improvement of his symptoms, and he made a full recovery. Allergy to chlorhexidine was confirmed with skin testing, and the patient was warned against all future exposure to chlorhexidine. Subsequent dialysis without chlorhexidine was uneventful.
一名患有终末期肾衰竭的54岁男性前来接受透析治疗。在将2%(重量/体积)氯己定(氯己定皮肤消毒剂3毫升涂抹器)涂抹于其透析导管(特西奥导管)插入点周围皮肤的几秒钟内,他出现了瘙痒、荨麻疹、呼吸急促、低血压和反应迟钝。随即启动了过敏反应治疗,其症状迅速改善,并完全康复。通过皮肤试验确诊对氯己定过敏,已警告该患者今后切勿再接触氯己定。随后在不使用氯己定的情况下进行透析,过程顺利。