(Non)dangerous antiseptic. Clinical case of confirmed drug allergy to chlorhexidine

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access

Abstract

One of the leading problems in modern allergology is drug hypersensitivity. There is an increase in allergic reactions to medications that are commonly used in routine practice.

The article presents a clinical case of a patient who developed anaphylaxis following the simultaneous administration of local anesthetics and chlorhexidine. Data on drug allergy to antiseptic agents are discussed. As a part of diagnostic workup in vitro and in vivo testing with suspected drugs was conducted, resulting in confirmation of drug allergy to chlorhexidine, which led to the prohibition of its use and ruled out allergy to local anesthetics.

About the authors

Anastasiya V. Pinchuk

National Research Center — Institute of Immunology Federal Medical-Biological Agency of Russia

Author for correspondence.
Email: AVPin13@yandex.ru
ORCID iD: 0009-0009-7472-8284

MD

Russian Federation, Moscow

Tatyana N. Myasnikova

National Research Center — Institute of Immunology Federal Medical-Biological Agency of Russia

Email: t_miasnikova@mail.ru
ORCID iD: 0000-0001-8491-195X
SPIN-code: 4684-3112

MD, Cand. Sci. (Medicine)

Russian Federation, Moscow

Elena A. Latysheva

National Research Center — Institute of Immunology Federal Medical-Biological Agency of Russia

Email: ealat@mail.ru
ORCID iD: 0000-0002-1606-205X
SPIN-code: 2063-7973

MD, Dr. Sci. (Medicine)

Russian Federation, Moscow

References

  1. Kalinin VM, Zhidkova UU, Vatanskaya OA. Development of an antiseptic product based on chlorgexidine bigluconate. Russian Military Medical Academy Reports. 2020;39(1–2S):81–84. (In Russ.) doi: 10.17816/rmmar43361
  2. Opstrup MS, Jemec GBE, Garvey LH. Chlorhexidine allergy: on the rise and often overlooked. Curr Allergy Asthma Rep. 2019;19(5):23. doi: 10.1007/s11882-019-0858-2 EDN: WHRYBM
  3. Barbaud A, Vigan M, Delrous JL, et al. Allergie de contact aux antiseptiques: 75 casanalysés par le réseau Revidal de dermato-allergovigilance. Ann Dermatol Venereol. 2005;132(12 Pt 1):962–965. (In French). doi: 10.1016/s0151-9638(05)79557-0
  4. Opstrup MS, Malling HJ, Krøigaard M, et al. Standardized testing with chlorhexidine in perioperative allergy — a large single-centre evaluation. Allergy. 2014;69(10):1390–1396. doi: 10.1111/all.12466
  5. Harper NJN, Cook TM, Garcez T, 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(1):159–171. doi: 10.1016/j.bja.2018.04.014
  6. Rose MA, Garcez T, Savic S, Garvey LH. Chlorhexidine allergy in the perioperative setting: a narrative review. Br J Anaesth. 2019;123(1):e95–e103. doi: 10.1016/j.bja.2019.01.033
  7. Gilbert P, Moore LE. Cationic antiseptics: diversity of action under a common epithet. J Appl Microbiol. 2005;99(4):703–715. doi: 10.1111/j.1365-2672.2005.02664.x
  8. Opstrup MS, Johansen JD, Zachariae C, Garvey LH. Contact allergy to chlorhexidine in a tertiary dermatology clinic in Denmark. Contact Dermatitis. 2016;74(1):29–36. doi: 10.1111/cod.2016.74.issue-1
  9. Garvey LH, Krøigaard M, Poulsen LK, et al. IgE-mediated allergy to chlorhexidine. J Allergy Clin Immunol. 2007;120(2):409–415. doi: 10.1016/j.jaci.2007.04.029
  10. Toletone A, Dini G, Massa E, 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(1):68–76. doi: 10.23749/mdl.v109i1.6618
  11. Sharp G, Green S, Rose M. Chlorhexidine-induced anaphylaxis in surgical patients: a review of the literature. ANZ J Surg. 2016;86(4):237–243. doi: 10.1111/ans.2016.86.issue-4
  12. Gerges BZ, Rosenblatt J, Truong YL, et al. Review of allergic reactions from use of chlorhexidine on medical products in clinical settings over 40 years: risks and mitigations. Infect Control Hosp Epidemiol. 2022;43(6):775–789. doi: 10.1017/ice.2021.150 EDN: UNGMCO
  13. Odedra KM, Farooque S. Chlorhexidine: an unrecognised cause of anaphylaxis. Postgrad Med J. 2014;90(1070):709–714. doi: 10.1136/postgradmedj-2013-132291
  14. Liippo J, Kousa P, Lammintausta K. The relevance of chlorhexidine contact allergy. Contact Dermatitis. 2011;64(4):229–234. doi: 10.1111/cod.2011.64.issue-4
  15. Ильина Н.И., Латышева Т.В., Мясникова Т.Н., Романова Т.С. Методические рекомендации по диагностике лекарственной аллергии. Москва: ФГБУ «ГНЦ Институт иммунологии» ФМБА России, 2022.

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2025 ABV-press

Согласие на обработку персональных данных

 

Используя сайт https://journals.rcsi.science, я (далее – «Пользователь» или «Субъект персональных данных») даю согласие на обработку персональных данных на этом сайте (текст Согласия) и на обработку персональных данных с помощью сервиса «Яндекс.Метрика» (текст Согласия).