A rare case of chlorhexidine- and clindamycin-induced anaphylaxis

Hao Xiao, Hongting Zhang, Juan Meng

Affiliation:
Allergy Center of Otolaryngology, Head and Neck Surgery Department, West China Hospital, Sichuan University, Chengdu, China

Abstract

Background: Chlorhexidine and clindamycin, especially the latter, rarely cause anaphylaxis.
Objective: To report a rare case of chlorhexidine- and clindamycin-induced anaphylaxis.
Methods: Case report
Results: A 21-year-old female experienced anaphylaxis after receiving intravenous clindamycin after a left big toe fracture fixation operation; she also had a similar reaction after using a mouthwash. Therefore, we suspected the culprit might be chlorhexidine, and the skin prick and serum specific IgE test results confirmed our suspicion. Then the clindamycin provocation test verified that the patient also had hypersensitivity to clindamycin. However, the allergy tests for penicillin and cefuroxime were negative.
Conclusion: Only four cases of clindamycin-induced anaphylaxis have been reported, and this is the first report of clindamycin-induced anaphylaxis verified by provocation test. The patient was given clindamycin because she was incorrectly labeled as having penicillin and cephalosporin allergies during the routine allergy test. It is essential to address this problem in China.
Key words: chlorhexidine, clindamycin, anaphylaxis, provocation test, β-lactam antibiotics