クロルヘキシジンによる周術期アナフィラキシーショックを来した1症例

Perioperative Anaphylactic Shock due to Chlorhexidine：A Case Report

要旨

　クロルヘキシジンは，幅広いスペクトルをもつ消毒薬として多用されている^1）。今回クロルヘキシジンによるアナフィラキシーショックを経験した。顔面の消毒に用いた消毒薬により高度頻脈，血圧低下を認め集中治療室に入室となった。回復後の皮内テストにより原因が特定され，予定された再手術を安全に施行することができた。

　Chlorhexidine is a broad-spectrum antiseptic that is widely used in medical practice and in the community, and clinicians should thus be aware of patients’ potential allergy to chlorhexidine even in the perioperative period. We describe the case of a patient who experienced anaphylactic shock induced by chlorhexidine. The patient, a 60-year-old male, developed severe tachycardia and hypotension after his face had been disinfected with chlorhexidine prior to a planned Endoscopic Sinus Surgery. He was admitted to the intensive care unit, where he recovered within 4hrs. A skin test was then performed, which revealed that the cause of the anaphylactic shock was the use of chlorhexidine. With the causative drug identified, we were able to safely perform the patient’s scheduled reoperation with the administration of general anesthesia.