Repeated Anaphylaxis due to Chlorhexidine Skin Application during Urological Operations: A Case Report

Chlorhexidine皮膚消毒液造成病人在泌尿科手術中多次過敏一病例報告

10.6200/TCMJ.2013.10.4.10

葉力仁(Li-Jen Yeh)；施勳彰(Hsun-Chang Shih)；林聖瀚(Sheng-Han Lin)；盧正淵(Cheng-Yuan Lu)

過敏 ； 麻醉 ； 泌尿科手術 ； 克羅赫絲錠 ； 消毒劑 ； anaphylaxis ； anesthesia ； urologic surgery ； chlorhexidine ； disinfectant

北市醫學雜誌

10卷4期（2013 / 12 / 30）

374 - 379

英文

Chlorhexidine今日在手術房逐漸被廣泛用作抗菌劑及消毒液。對chlorhexidine過敏是很少的，而因chlorhexidine用作皮膚消毒液，所引起過敏的案例更是少見。一名53歲的男性病人，於三次不同的泌尿科手術中，分別接受全身麻醉、半身麻醉以及靜脈麻醉，發生三次原因不明的休克現象。這位病人手術部位的皮膚是用Chlorhexidine消毒液消毒的。後來病人血清中chlorhexidine的特異IgE呈現陽性反應，同時也排除了其他可疑的藥物及藥劑。我們必須知道chlorhexidine是可以引起過敏的，即使只是用在皮膚消毒，本文的探討是可以減低病人對藥物副作用的風險。

Chlorhexidine is an antiseptics and disinfectant for operating rooms. Anaphylaxis to chlorhexidine is rare, and anaphylaxis to chlorhexidine due to skin application is even rarer. A 53-year-old male patient had three unexplained anaphylactic shock episodes during three consecutive, individual, urological operations under general anesthesia, spinal anesthesia and intravenous general anesthesia, respectively. Chlorhexidine was used as a skin disinfectant for this patient. Later, serum chlorhexidine specific IgE revealed positive result, with suspected drugs and chemicals ruled out. Health care workers should be aware of a potential allergen property of chlorhexidine even when applied on skin.