Terazawa E, Nagase K, Masue T, Niwa Y, Fukao I, Shimonaka H, Yokoi T, Kondoh N, Dohi S
Department of Anesthesiology, Gifu Prefectural Hospital.
Masui. 1998 May;47(5):556-61.
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.
一名28岁男性患者曾多次发生过敏性休克，可能是由于接触了浸渍有洗必泰和磺胺嘧啶银的中心静脉导管。他成功复苏。在第二次手术中，过敏性休克后不久，血液嗜碱性粒细胞消失，血浆组胺水平急剧升高至80 ng.ml-1。首次休克一年后，他在插入未浸渍的中心静脉导管后未发生过敏性休克。点刺试验和划痕试验仅对洗必泰呈阳性反应。未检测到乳胶特异性抗IgE抗体。因此，洗必泰被确认为过敏性休克的致病因素。由于洗必泰在急诊室和重症监护病房广泛用作抗菌药物，我们应意识到洗必泰诱发过敏反应的可能性。
