Skip to main content
Erschienen in: Current Allergy and Asthma Reports 5/2019

01.05.2019 | Anaphylaxis and Drug Allergy (DA Khan and M Castells, Section Editors)

Chlorhexidine Allergy: On the Rise and Often Overlooked

verfasst von: Morten Schjørring Opstrup, Gregor Borut Ernst Jemec, Lene Heise Garvey

Erschienen in: Current Allergy and Asthma Reports | Ausgabe 5/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

In recent years, the risk of allergy to chlorhexidine is increasingly recognised. In this review, we discuss why the allergy is so easily overlooked and point out several preventative initiatives that can minimise the risk of both chlorhexidine sensitisation and allergy development and accidental re-exposure in patients with chlorhexidine allergy. Testing for chlorhexidine allergy is also discussed.

Recent Findings

Numerous reports have been published from many different specialties. Symptoms range from mild skin symptoms to life-threatening anaphylaxis. Testing for chlorhexidine allergy is based on skin testing and in vitro testing. Recently, it was found that both skin prick testing and specific IgE have high sensitivities and specificities.

Summary

This review gives an overview of chlorhexidine allergy with a special focus on preventative initiatives and testing.
Literatur
2.
Zurück zum Zitat Lim KS, Kam PC. Chlorhexidine—pharmacology and clinical applications. Anaesth Intensive Care. 2008;36:502–12.CrossRef Lim KS, Kam PC. Chlorhexidine—pharmacology and clinical applications. Anaesth Intensive Care. 2008;36:502–12.CrossRef
3.
Zurück zum Zitat • Sharp G, Green S, Rose M. Chlorhexidine-induced anaphylaxis in surgical patients: a review of the literature. ANZ J Surg. 2016;86:237–43 A systematic review on chlorhexidine allergy. CrossRef • Sharp G, Green S, Rose M. Chlorhexidine-induced anaphylaxis in surgical patients: a review of the literature. ANZ J Surg. 2016;86:237–43 A systematic review on chlorhexidine allergy. CrossRef
4.
Zurück zum Zitat Pemberton MN, Gibson J. Chlorhexidine and hypersensitivity reactions in dentistry. Br Dent J. 2012;213:547–50.CrossRef Pemberton MN, Gibson J. Chlorhexidine and hypersensitivity reactions in dentistry. Br Dent J. 2012;213:547–50.CrossRef
5.
Zurück zum Zitat •• Opstrup MS, Poulsen LK, Malling HJ, Jensen BM, Garvey LH. Dynamics of plasma levels of specific IgE in chlorhexidine allergic patients with and without accidental re-exposure. Clin Exp Allergy. 2016;46:1090–8 Study showing the dynamics of plasma levels in chlorhexidine allergy. CrossRef •• Opstrup MS, Poulsen LK, Malling HJ, Jensen BM, Garvey LH. Dynamics of plasma levels of specific IgE in chlorhexidine allergic patients with and without accidental re-exposure. Clin Exp Allergy. 2016;46:1090–8 Study showing the dynamics of plasma levels in chlorhexidine allergy. CrossRef
6.
Zurück zum Zitat Davies GE, Francis J, Martin AR, Rose FL, Swain G. 1:6-Di-4′-chlorophenyldiguanidohexane (hibitane); laboratory investigation of a new antibacterial agent of high potency. Br J Pharmacol Chemother. 1954;9:192–6.CrossRef Davies GE, Francis J, Martin AR, Rose FL, Swain G. 1:6-Di-4′-chlorophenyldiguanidohexane (hibitane); laboratory investigation of a new antibacterial agent of high potency. Br J Pharmacol Chemother. 1954;9:192–6.CrossRef
7.
Zurück zum Zitat Noorani A, Rabey N, Walsh SR, Davies RJ. Systematic review and meta-analysis of preoperative antisepsis with chlorhexidine versus povidone-iodine in clean-contaminated surgery. Br J Surg. 2010;97:1614–20.CrossRef Noorani A, Rabey N, Walsh SR, Davies RJ. Systematic review and meta-analysis of preoperative antisepsis with chlorhexidine versus povidone-iodine in clean-contaminated surgery. Br J Surg. 2010;97:1614–20.CrossRef
8.
Zurück zum Zitat Opstrup MS, Johansen JD, Garvey LH. Chlorhexidine allergy: sources of exposure in the health-care setting. Br J Anaesth. 2015;114:704–5.CrossRef Opstrup MS, Johansen JD, Garvey LH. Chlorhexidine allergy: sources of exposure in the health-care setting. Br J Anaesth. 2015;114:704–5.CrossRef
9.
Zurück zum Zitat Silvestri DL, McEnery-Stonelake M. Chlorhexidine: uses and adverse reactions. Dermatitis. 2013;24:112–8.CrossRef Silvestri DL, McEnery-Stonelake M. Chlorhexidine: uses and adverse reactions. Dermatitis. 2013;24:112–8.CrossRef
10.
Zurück zum Zitat • Stewart M, Lenaghan D. The danger of chlorhexidine in lignocaine gel: a case report of anaphylaxis during urinary catheterisation. Australas Med J. 2015;8:304–6 Case report discussing whether chlorhexidine is needed in urethral gels. CrossRef • Stewart M, Lenaghan D. The danger of chlorhexidine in lignocaine gel: a case report of anaphylaxis during urinary catheterisation. Australas Med J. 2015;8:304–6 Case report discussing whether chlorhexidine is needed in urethral gels. CrossRef
11.
Zurück zum Zitat Odedra KM, Farooque S. Chlorhexidine : an unrecognised cause of anaphylaxis. Postgrad Med J. 2014;90:709–14.CrossRef Odedra KM, Farooque S. Chlorhexidine : an unrecognised cause of anaphylaxis. Postgrad Med J. 2014;90:709–14.CrossRef
12.
Zurück zum Zitat Opstrup MS, Johansen JD, Bossi R, Lundov MD, Garvey LH. Chlorhexidine in cosmetic products—a market survey. Contact Dermatitis. 2015;72:55–8.CrossRef Opstrup MS, Johansen JD, Bossi R, Lundov MD, Garvey LH. Chlorhexidine in cosmetic products—a market survey. Contact Dermatitis. 2015;72:55–8.CrossRef
13.
Zurück zum Zitat Nishioka K, Doi T, Katayama I. Histamine release in contact urticaria. Contact Dermatitis. 1984;11:191.CrossRef Nishioka K, Doi T, Katayama I. Histamine release in contact urticaria. Contact Dermatitis. 1984;11:191.CrossRef
14.
Zurück zum Zitat Okano M, Nomura M, Hata S, Okada N, Sato K, Kitano Y, et al. Anaphylactic symptoms due to chlorhexidine gluconate. Arch Dermatol. 1989;125:50–2.CrossRef Okano M, Nomura M, Hata S, Okada N, Sato K, Kitano Y, et al. Anaphylactic symptoms due to chlorhexidine gluconate. Arch Dermatol. 1989;125:50–2.CrossRef
15.
Zurück zum Zitat Ohtoshi T, Yamauchi N, Tadokoro K, Miyachi S, Suzuki S, Miyamoto T, et al. IgE antibody-mediated shock reaction caused by topical application of chlorhexidine. Clin Allergy. 1986;16:155–61.CrossRef Ohtoshi T, Yamauchi N, Tadokoro K, Miyachi S, Suzuki S, Miyamoto T, et al. IgE antibody-mediated shock reaction caused by topical application of chlorhexidine. Clin Allergy. 1986;16:155–61.CrossRef
16.
Zurück zum Zitat Fujita S, Sumita S, Kawana S, Iwasaki H, Namiki A. Two cases of anaphylactic shock induced by chlorhexidine. Masui. 1997;46:1118–21.PubMed Fujita S, Sumita S, Kawana S, Iwasaki H, Namiki A. Two cases of anaphylactic shock induced by chlorhexidine. Masui. 1997;46:1118–21.PubMed
17.
Zurück zum Zitat Okuda T, Funasaka M, Arimitsu M, Umeda T, Wakita K, Koga Y. Anaphylactic shock by ophthalmic wash solution containing chlorhexidine. Masui. 1994;43:1352–5.PubMed Okuda T, Funasaka M, Arimitsu M, Umeda T, Wakita K, Koga Y. Anaphylactic shock by ophthalmic wash solution containing chlorhexidine. Masui. 1994;43:1352–5.PubMed
18.
Zurück zum Zitat Oda T, Hamasaki J, Kanda N, Mikami K. Anaphylactic shock induced by an antiseptic-coated central venous [correction of nervous] catheter. Anaesthesiology. 1997;87:1242–4.CrossRef Oda T, Hamasaki J, Kanda N, Mikami K. Anaphylactic shock induced by an antiseptic-coated central venous [correction of nervous] catheter. Anaesthesiology. 1997;87:1242–4.CrossRef
19.
Zurück zum Zitat Garvey L. Old, new and hidden causes of perioperative hypersensitivity. Curr Pharm Des. 2016;22:6814–24.CrossRef Garvey L. Old, new and hidden causes of perioperative hypersensitivity. Curr Pharm Des. 2016;22:6814–24.CrossRef
20.
Zurück zum Zitat • Rutkowski K, Wagner A. Chlorhexidine: a new latex? Eur Urol. 2015;68:345–7 Review discussing the similarities between chlorhexidine and latex. CrossRef • Rutkowski K, Wagner A. Chlorhexidine: a new latex? Eur Urol. 2015;68:345–7 Review discussing the similarities between chlorhexidine and latex. CrossRef
21.
Zurück zum Zitat Garvey LH, Hunter JM. Changing culprits in perioperative anaphylaxis. Br J Anaesth. 2018;121:114–7.CrossRef Garvey LH, Hunter JM. Changing culprits in perioperative anaphylaxis. Br J Anaesth. 2018;121:114–7.CrossRef
22.
Zurück zum Zitat Nakonechna A, Dore P, Dixon T, Khan S, Deacock S, Holding S, et al. Immediate hypersensitivity to chlorhexidine is increasingly recognised in the United Kingdom. Allergol Immunopathol. 2014;42:44–9.CrossRef Nakonechna A, Dore P, Dixon T, Khan S, Deacock S, Holding S, et al. Immediate hypersensitivity to chlorhexidine is increasingly recognised in the United Kingdom. Allergol Immunopathol. 2014;42:44–9.CrossRef
23.
Zurück zum Zitat Opstrup MS, Garvey LH (2019) Chlorhexidine allergy: mild allergic reactions can precede anaphylaxis in the healthcare setting—a case report. Turk J Anaesthesiol Reanim; Accepted. Opstrup MS, Garvey LH (2019) Chlorhexidine allergy: mild allergic reactions can precede anaphylaxis in the healthcare setting—a case report. Turk J Anaesthesiol Reanim; Accepted.
24.
Zurück zum Zitat Koch A, Wollina U. Chlorhexidine allergy. Allergo J Int. 2014;23:84–6.CrossRef Koch A, Wollina U. Chlorhexidine allergy. Allergo J Int. 2014;23:84–6.CrossRef
25.
Zurück zum Zitat Dick AG, Dhinsa B, Walker RP, Singh S. Delayed allergic reaction to ChloraPrepTM in foot and ankle surgery. J Foot Ankle Surg. 2018;58:2018–20. Dick AG, Dhinsa B, Walker RP, Singh S. Delayed allergic reaction to ChloraPrepTM in foot and ankle surgery. J Foot Ankle Surg. 2018;58:2018–20.
26.
Zurück zum Zitat Postolova A, Bradley JT, Parris D, Sherr J, McGhee SA, Hernandez JD. Anaphylaxis to invasive chlorhexidine administration despite tolerance of topical chlorhexidine use. J Allergy Clin Immunol Pract. 2018;6:1067–1069.e1.CrossRef Postolova A, Bradley JT, Parris D, Sherr J, McGhee SA, Hernandez JD. Anaphylaxis to invasive chlorhexidine administration despite tolerance of topical chlorhexidine use. J Allergy Clin Immunol Pract. 2018;6:1067–1069.e1.CrossRef
27.
Zurück zum Zitat Kow RY, Low CL, Ruben JK, Zaharul-Azri MZ, Ng MS. Life-threatening chlorhexidine anaphylaxis: a case report. Malaysian Orthop J. 2017;11:72–4.CrossRef Kow RY, Low CL, Ruben JK, Zaharul-Azri MZ, Ng MS. Life-threatening chlorhexidine anaphylaxis: a case report. Malaysian Orthop J. 2017;11:72–4.CrossRef
28.
Zurück zum Zitat Hong CC, Wang SM, Nather A, Tan JH, Tay SH, Poon KH. Chlorhexidine anaphylaxis masquerading as septic shock. Int Arch Allergy Immunol. 2015;167:16–20.CrossRef Hong CC, Wang SM, Nather A, Tan JH, Tay SH, Poon KH. Chlorhexidine anaphylaxis masquerading as septic shock. Int Arch Allergy Immunol. 2015;167:16–20.CrossRef
30.
Zurück zum Zitat Wang ML, Chang CT, Huang HH, Yeh YC, Lee TS, Hung KY. Chlorhexidine-related refractory anaphylactic shock: a case successfully resuscitated with extracorporeal membrane oxygenation. J Clin Anesth. 2016;34:654–7.CrossRef Wang ML, Chang CT, Huang HH, Yeh YC, Lee TS, Hung KY. Chlorhexidine-related refractory anaphylactic shock: a case successfully resuscitated with extracorporeal membrane oxygenation. J Clin Anesth. 2016;34:654–7.CrossRef
31.
Zurück zum Zitat Spoerl D, Jandus P, Harr T. Pitfalls and peculiarities in chlorhexidine allergy. J Allergy Clin Immunol Pract. 2016;4:991–2.CrossRef Spoerl D, Jandus P, Harr T. Pitfalls and peculiarities in chlorhexidine allergy. J Allergy Clin Immunol Pract. 2016;4:991–2.CrossRef
32.
Zurück zum Zitat Weng M, Zhu M, Chen W, Miao C. Case report life-threatening anaphylactic shock due to chlorhexidine on the central venous catheter : a case series. Int J Clin Exp Med. 2014;7:5930–6.PubMedPubMedCentral Weng M, Zhu M, Chen W, Miao C. Case report life-threatening anaphylactic shock due to chlorhexidine on the central venous catheter : a case series. Int J Clin Exp Med. 2014;7:5930–6.PubMedPubMedCentral
33.
34.
Zurück zum Zitat Kofod C, Eriksen S, Garvey LH. Anafylaktisk shock udløst af klorhexidinskylning hos tandlæge. Tandlægebladet. 2017;121:336–9. Kofod C, Eriksen S, Garvey LH. Anafylaktisk shock udløst af klorhexidinskylning hos tandlæge. Tandlægebladet. 2017;121:336–9.
35.
Zurück zum Zitat Gu JQ, Liu S, Zhi YX. Provocation test—confirmed chlorhexidine—induced anaphylaxis in dental procedure. Chin Med J. 2018;131:2893–4.CrossRef Gu JQ, Liu S, Zhi YX. Provocation test—confirmed chlorhexidine—induced anaphylaxis in dental procedure. Chin Med J. 2018;131:2893–4.CrossRef
37.
Zurück zum Zitat Cogné Y, Mouton-Faivre C, Cavasino T, Teychene AM, de Pontual L, Dewachter P. Chlorhexidine-induced IgE-mediated allergy in a 6-year-old child. J Allergy Clin Immunol Pract. 2017;5:837–8.CrossRef Cogné Y, Mouton-Faivre C, Cavasino T, Teychene AM, de Pontual L, Dewachter P. Chlorhexidine-induced IgE-mediated allergy in a 6-year-old child. J Allergy Clin Immunol Pract. 2017;5:837–8.CrossRef
38.
Zurück zum Zitat Lasa EM, González C, García-Lirio E, Martínez S, Arroabarren E, Gamboa PM. Anaphylaxis caused by immediate hypersensitivity to topical chlorhexidine in children. Ann Allergy Asthma Immunol. 2017;118:118–9.CrossRef Lasa EM, González C, García-Lirio E, Martínez S, Arroabarren E, Gamboa PM. Anaphylaxis caused by immediate hypersensitivity to topical chlorhexidine in children. Ann Allergy Asthma Immunol. 2017;118:118–9.CrossRef
39.
Zurück zum Zitat Mushtaq U, Tan A, Tan JA, Smith WB. Acute allergic reaction after intravenous saline injection: an unusual presentation of chlorhexidine allergy. Med J Aust. 2014;200:599–600.CrossRef Mushtaq U, Tan A, Tan JA, Smith WB. Acute allergic reaction after intravenous saline injection: an unusual presentation of chlorhexidine allergy. Med J Aust. 2014;200:599–600.CrossRef
40.
Zurück zum Zitat •• Opstrup MS, Malling H-J, Krøigaard M, Mosbech H, Skov PS, Poulsen LK, et al. Standardized testing with chlorhexidine in perioperative allergy—a large single-centre evaluation. Allergy. 2014;69:1390–6 A study investigating the value of the diagnostic tests in chlorhexidine allergy. CrossRef •• Opstrup MS, Malling H-J, Krøigaard M, Mosbech H, Skov PS, Poulsen LK, et al. Standardized testing with chlorhexidine in perioperative allergy—a large single-centre evaluation. Allergy. 2014;69:1390–6 A study investigating the value of the diagnostic tests in chlorhexidine allergy. CrossRef
41.
Zurück zum Zitat •• Egner W, Helbert M, Sargur R, Swallow K, Harper N, Garcez T, et al. Chlorhexidine allergy in four specialist allergy centres in the United Kingdom, 2009–13: clinical features and diagnostic tests. Clin Exp Immunol. 2017;188:380–6 A study characterizing patients with chlorhexidine allergy and evaluating the diagnostic tests in the United Kingdom. CrossRef •• Egner W, Helbert M, Sargur R, Swallow K, Harper N, Garcez T, et al. Chlorhexidine allergy in four specialist allergy centres in the United Kingdom, 2009–13: clinical features and diagnostic tests. Clin Exp Immunol. 2017;188:380–6 A study characterizing patients with chlorhexidine allergy and evaluating the diagnostic tests in the United Kingdom. CrossRef
42.
Zurück zum Zitat Harper NJN, Cook TM, Garcez T, Farmer L, Floss K, Marinho S, et al. Anaesthesia, surgery, and life-threatening allergic reactions: epidemiology and clinical features of perioperative anaphylaxis in the 6th National Audit Project (NAP6). Br J Anaesth. 2018;121:159–71.CrossRef Harper NJN, Cook TM, Garcez T, Farmer L, Floss K, Marinho S, et al. Anaesthesia, surgery, and life-threatening allergic reactions: epidemiology and clinical features of perioperative anaphylaxis in the 6th National Audit Project (NAP6). Br J Anaesth. 2018;121:159–71.CrossRef
43.
Zurück zum Zitat Leysen J, De Witte L, Bridts CH, Ebo DG. Anaphylaxis during general anaesthesia : a 10-year survey 1 at the University Hospital of Antwerp. P Belg Roy Acad Med. 2013;2:88–100. Leysen J, De Witte L, Bridts CH, Ebo DG. Anaphylaxis during general anaesthesia : a 10-year survey 1 at the University Hospital of Antwerp. P Belg Roy Acad Med. 2013;2:88–100.
44.
Zurück zum Zitat Harper NJN, Cook TM, Garcez T, Lucas DN, Thomas M, Kemp H, et al. Anaesthesia, surgery, and life-threatening allergic reactions: management and outcomes in the 6th National Audit Project (NAP6). Br J Anaesth. 2018;121:172–88.CrossRef Harper NJN, Cook TM, Garcez T, Lucas DN, Thomas M, Kemp H, et al. Anaesthesia, surgery, and life-threatening allergic reactions: management and outcomes in the 6th National Audit Project (NAP6). Br J Anaesth. 2018;121:172–88.CrossRef
45.
Zurück zum Zitat Scolaro RJ, Crilly HM, Maycock EJ, McAleer PT, Nicholls KA, Rose MA, et al. Australian and New Zealand Anaesthetic Allergy Group perioperative anaphylaxis investigation guidelines. Anaesth Intensive Care. 2017;45:543–55.CrossRef Scolaro RJ, Crilly HM, Maycock EJ, McAleer PT, Nicholls KA, Rose MA, et al. Australian and New Zealand Anaesthetic Allergy Group perioperative anaphylaxis investigation guidelines. Anaesth Intensive Care. 2017;45:543–55.CrossRef
51.
Zurück zum Zitat Toletone A, Dini G, Massa E, Bragazzi NL, Pignatti P, Voltolini S, et al. Chlorhexidine-induced anaphylaxis occurring in the workplace in a health-care worker: case report and review of the literature. Med Lav. 2018;109:68–76.PubMed Toletone A, Dini G, Massa E, Bragazzi NL, Pignatti P, Voltolini S, et al. Chlorhexidine-induced anaphylaxis occurring in the workplace in a health-care worker: case report and review of the literature. Med Lav. 2018;109:68–76.PubMed
52.
Zurück zum Zitat Vu M, Rajgopal Bala H, Cahill J, Toholka R, Nixon R. Immediate hypersensitivity to chlorhexidine. Aus J Dermatol. 2018;59:55–6.CrossRef Vu M, Rajgopal Bala H, Cahill J, Toholka R, Nixon R. Immediate hypersensitivity to chlorhexidine. Aus J Dermatol. 2018;59:55–6.CrossRef
53.
Zurück zum Zitat Wittczak T, Dudek W, Walusiak-Skorupa J, Świerczyńska-Machura D, Pałczyński C. Chlorhexidine--still an underestimated allergic hazard for health care professionals. Occup Med (Lond). 2013;63:301–5.CrossRef Wittczak T, Dudek W, Walusiak-Skorupa J, Świerczyńska-Machura D, Pałczyński C. Chlorhexidine--still an underestimated allergic hazard for health care professionals. Occup Med (Lond). 2013;63:301–5.CrossRef
54.
Zurück zum Zitat Sato K, Kusaka Y, Suganuma N, Nagasawa S, Deguchi Y. Occupational allergy in medical doctors. J Occup Health. 2004;46:165–70.CrossRef Sato K, Kusaka Y, Suganuma N, Nagasawa S, Deguchi Y. Occupational allergy in medical doctors. J Occup Health. 2004;46:165–70.CrossRef
55.
Zurück zum Zitat • Nagendran V, Wicking J, Ekbote A, Onyekwe T, Garvey LH. IgE-mediated chlorhexidine allergy: a new occupational hazard? Occup Med (Lond). 2009;59:270–2 Important study about the occupational risk of chlorhexidine allergy. CrossRef • Nagendran V, Wicking J, Ekbote A, Onyekwe T, Garvey LH. IgE-mediated chlorhexidine allergy: a new occupational hazard? Occup Med (Lond). 2009;59:270–2 Important study about the occupational risk of chlorhexidine allergy. CrossRef
56.
Zurück zum Zitat Ibler KS, Jemec GBE, Garvey LH, Agner T. Prevalence of delayed-type and immediate-type hypersensitivity in healthcare workers with hand eczema. Contact Dermatitis. 2016;75:223–9.CrossRef Ibler KS, Jemec GBE, Garvey LH, Agner T. Prevalence of delayed-type and immediate-type hypersensitivity in healthcare workers with hand eczema. Contact Dermatitis. 2016;75:223–9.CrossRef
57.
Zurück zum Zitat Garvey LH, Roed-Petersen J, Husum B. Is there a risk of sensitization and allergy to chlorhexidine in health care workers? Acta Anaesthesiol Scand. 2003;47:720–4.CrossRef Garvey LH, Roed-Petersen J, Husum B. Is there a risk of sensitization and allergy to chlorhexidine in health care workers? Acta Anaesthesiol Scand. 2003;47:720–4.CrossRef
58.
Zurück zum Zitat Garvey LH, Roed-Petersen J, Husum B. Anaphylactic reactions in anaesthetised patients—four cases of chlorhexidine allergy. Acta Anaesthesiol Scand. 2001;45:1290–4.CrossRef Garvey LH, Roed-Petersen J, Husum B. Anaphylactic reactions in anaesthetised patients—four cases of chlorhexidine allergy. Acta Anaesthesiol Scand. 2001;45:1290–4.CrossRef
59.
Zurück zum Zitat •• Garvey LH, Krøigaard M, Poulsen LK, Skov PS, Mosbech H, Venemalm L, et al. IgE-mediated allergy to chlorhexidine. J Allergy Clin Immunol. 2007;120:409–15 A study where it was shown that chlorhexidine allergy is IgE mediated. CrossRef •• Garvey LH, Krøigaard M, Poulsen LK, Skov PS, Mosbech H, Venemalm L, et al. IgE-mediated allergy to chlorhexidine. J Allergy Clin Immunol. 2007;120:409–15 A study where it was shown that chlorhexidine allergy is IgE mediated. CrossRef
60.
Zurück zum Zitat Jee R, Nel L, Gnanakumaran G, Williams A, Eren E. Four cases of anaphylaxis to chlorhexidine impregnated central venous catheters: a case cluster or the tip of the iceberg. Br J Anaesth. 2009;103:614–5.CrossRef Jee R, Nel L, Gnanakumaran G, Williams A, Eren E. Four cases of anaphylaxis to chlorhexidine impregnated central venous catheters: a case cluster or the tip of the iceberg. Br J Anaesth. 2009;103:614–5.CrossRef
61.
Zurück zum Zitat Dyer JE, Nafie S, Mellon JK, Khan MA. Anaphylactic reaction to intraurethral chlorhexidine: sensitisation following previous repeated uneventful administration. Ann R Coll Surg Engl. 2013;95:e105–6.CrossRef Dyer JE, Nafie S, Mellon JK, Khan MA. Anaphylactic reaction to intraurethral chlorhexidine: sensitisation following previous repeated uneventful administration. Ann R Coll Surg Engl. 2013;95:e105–6.CrossRef
62.
Zurück zum Zitat Kroigaard M, Garvey LH, Menne T, Husum B. Allergic reactions in anaesthesia: are suspected causes confirmed on subsequent testing? Br J Anaesth. 2005;95:468–71.CrossRef Kroigaard M, Garvey LH, Menne T, Husum B. Allergic reactions in anaesthesia: are suspected causes confirmed on subsequent testing? Br J Anaesth. 2005;95:468–71.CrossRef
63.
Zurück zum Zitat Christiansen IS, Krøigaard M, Mosbech H, Skov PS, Poulsen LK, Garvey LH. Clinical and diagnostic features of perioperative hypersensitivity to cefuroxime. Clin Exp Allergy. 2015;45:807–14.CrossRef Christiansen IS, Krøigaard M, Mosbech H, Skov PS, Poulsen LK, Garvey LH. Clinical and diagnostic features of perioperative hypersensitivity to cefuroxime. Clin Exp Allergy. 2015;45:807–14.CrossRef
64.
Zurück zum Zitat Aschenbrenner DS. Rare allergic reaction to topical chlorhexidine gluconate. Am J Nurs. 2017;117:20.PubMed Aschenbrenner DS. Rare allergic reaction to topical chlorhexidine gluconate. Am J Nurs. 2017;117:20.PubMed
65.
Zurück zum Zitat 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. 2012;13:171–4.CrossRef 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. 2012;13:171–4.CrossRef
66.
Zurück zum Zitat Loveday HP, Wilson JA, Pratt RJ, Golsorkhi M, Tingle A, Bak A, et al. Epic3: national evidence-based guidelines for preventing healthcare-associated infections in nhs hospitals in England. J Hosp Infect. 2014;86(S1):S1–70.CrossRef Loveday HP, Wilson JA, Pratt RJ, Golsorkhi M, Tingle A, Bak A, et al. Epic3: national evidence-based guidelines for preventing healthcare-associated infections in nhs hospitals in England. J Hosp Infect. 2014;86(S1):S1–70.CrossRef
67.
Zurück zum Zitat Geng V, Cobussen-Boekhorst H, FarrelI J, Gea-Sánchez M, Pearce I, Schwennesen T, et al. (2012) Catheterisation. Indwelling catheters in adults, urethral and suprapubic. Eur Assoc Urol Nurses;112. Geng V, Cobussen-Boekhorst H, FarrelI J, Gea-Sánchez M, Pearce I, Schwennesen T, et al. (2012) Catheterisation. Indwelling catheters in adults, urethral and suprapubic. Eur Assoc Urol Nurses;112.
69.
Zurück zum Zitat Williams C. Making a choice of catheterisation gel and the role of chlorhexidine. Br J Community Nurs. 2017;22:346–51.CrossRef Williams C. Making a choice of catheterisation gel and the role of chlorhexidine. Br J Community Nurs. 2017;22:346–51.CrossRef
70.
Zurück zum Zitat Stephens R, Mythen M, Kallis P, Davies DW, Egner W, Rickards A. Two episodes of life-threatening anaphylaxis in the same patient to a chlorhexidine-sulphadiazine-coated central venous catheter. Br J Anaesth. 2001;87:306–8.CrossRef Stephens R, Mythen M, Kallis P, Davies DW, Egner W, Rickards A. Two episodes of life-threatening anaphylaxis in the same patient to a chlorhexidine-sulphadiazine-coated central venous catheter. Br J Anaesth. 2001;87:306–8.CrossRef
71.
Zurück zum Zitat Khoo A, Oziemski P. Chlorhexidine impregnated central venous catheter inducing an anaphylatic shock in the intensive care unit. Heart Lung Circ. 2011;20:669–70.CrossRef Khoo A, Oziemski P. Chlorhexidine impregnated central venous catheter inducing an anaphylatic shock in the intensive care unit. Heart Lung Circ. 2011;20:669–70.CrossRef
72.
Zurück zum Zitat Chong HY, Lai NM, Apisarnthanarak A, Chaiyakunapruk N. Comparative efficacy of antimicrobial central venous catheters in reducing catheter-related bloodstream infections in adults: abridged cochrane systematic review and network meta-analysis. Clin Infect Dis. 2017;64(suppl_2):S131–40.CrossRef Chong HY, Lai NM, Apisarnthanarak A, Chaiyakunapruk N. Comparative efficacy of antimicrobial central venous catheters in reducing catheter-related bloodstream infections in adults: abridged cochrane systematic review and network meta-analysis. Clin Infect Dis. 2017;64(suppl_2):S131–40.CrossRef
75.
Zurück zum Zitat Chen P, Huda W, Levy N. Chlorhexidine anaphylaxis: implications for post-resuscitation management. Anaesthesia. 2016;71:242–3.CrossRef Chen P, Huda W, Levy N. Chlorhexidine anaphylaxis: implications for post-resuscitation management. Anaesthesia. 2016;71:242–3.CrossRef
76.
Zurück zum Zitat Brockow K, Garvey LH, Aberer W, Atanaskovic-Markovic M, Barbaud A, Bilo MB, et al. Skin test concentrations for systemically administered drugs—an ENDA/EAACI Drug Allergy Interest Group position paper. Allergy. 2013;68:702–12.CrossRef Brockow K, Garvey LH, Aberer W, Atanaskovic-Markovic M, Barbaud A, Bilo MB, et al. Skin test concentrations for systemically administered drugs—an ENDA/EAACI Drug Allergy Interest Group position paper. Allergy. 2013;68:702–12.CrossRef
77.
Zurück zum Zitat Mertes PM, Malinovsky JM, Jouffroy L, Aberer W, Terreehorst I, Brockow K, et al. Reducing the risk of anaphylaxis during anesthesia: 2011 updated guidelines for clinical practice. J Investig Allergol Clin Immunol. 2011;21:442–53.PubMed Mertes PM, Malinovsky JM, Jouffroy L, Aberer W, Terreehorst I, Brockow K, et al. Reducing the risk of anaphylaxis during anesthesia: 2011 updated guidelines for clinical practice. J Investig Allergol Clin Immunol. 2011;21:442–53.PubMed
78.
Zurück zum Zitat Brockow K, Romano A, Blanca M, Ring J, Pichler W, Demoly P. General considerations for skin test procedures in the diagnosis of drug hypersensitivity. Allergy. 2002;57:45–51.PubMed Brockow K, Romano A, Blanca M, Ring J, Pichler W, Demoly P. General considerations for skin test procedures in the diagnosis of drug hypersensitivity. Allergy. 2002;57:45–51.PubMed
79.
Zurück zum Zitat Fisher MM, Bowey CJ. Intradermal compared with prick testing in the diagnosis of anaesthetic allergy. Br J Anaesth. 1997;79:59–63.CrossRef Fisher MM, Bowey CJ. Intradermal compared with prick testing in the diagnosis of anaesthetic allergy. Br J Anaesth. 1997;79:59–63.CrossRef
80.
Zurück zum Zitat • Anderson J, Rose M, Green S, Fernando SL. The utility of specific IgE testing to chlorhexidine in the investigation of perioperative adverse reactions. Ann Allergy Asthma Immunol. 2015;114:425–426.e1 Study investigating the value of specific IgE to chlorhexidine. CrossRef • Anderson J, Rose M, Green S, Fernando SL. The utility of specific IgE testing to chlorhexidine in the investigation of perioperative adverse reactions. Ann Allergy Asthma Immunol. 2015;114:425–426.e1 Study investigating the value of specific IgE to chlorhexidine. CrossRef
81.
Zurück zum Zitat Leysen J, Bridts CH, De Clerck LS, Vercauteren M, Lambert J, Weyler JJ, et al. Allergy to rocuronium: from clinical suspicion to correct diagnosis. Allergy. 2011;66:1014–9.CrossRef Leysen J, Bridts CH, De Clerck LS, Vercauteren M, Lambert J, Weyler JJ, et al. Allergy to rocuronium: from clinical suspicion to correct diagnosis. Allergy. 2011;66:1014–9.CrossRef
Metadaten
Titel
Chlorhexidine Allergy: On the Rise and Often Overlooked
verfasst von
Morten Schjørring Opstrup
Gregor Borut Ernst Jemec
Lene Heise Garvey
Publikationsdatum
01.05.2019
Verlag
Springer US
Erschienen in
Current Allergy and Asthma Reports / Ausgabe 5/2019
Print ISSN: 1529-7322
Elektronische ISSN: 1534-6315
DOI
https://doi.org/10.1007/s11882-019-0858-2

Weitere Artikel der Ausgabe 5/2019

Current Allergy and Asthma Reports 5/2019 Zur Ausgabe

Anaphylaxis and Drug Allergy (DA Khan and M Castells, Section Editors)

Evaluating Penicillin Allergies Without Skin Testing

Basic and Applied Science (I Lewkowich, Section Editor)

Exosomes in Allergic Airway Diseases

Basic and Applied Science (I Lewkowich, Section Editor)

Th9 Cells in Allergic Disease

Immunotherapy and Immunomodulators (B Vickery, Section Editor)

Microbial Adjuncts for Food Allergen Immunotherapy

Rhinosinusitis (J Mullol, Section Editor)

Osteitis in Chronic Rhinosinusitis

Update HNO

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.