Perioperative cardiovascular collapse triggered by a chlorhexidine-coated central venous catheter: a case report and review of the literature

Although widely used to mitigate catheter-related bloodstream infections, chlorhexidine-coated central venous catheters (CVCs) are a rare but critical cause of anaphylaxis. We present the case of a 57-year-old Chinese male who experienced severe anaphylactic shock immediately after the insertion of a chlorhexidine-impregnated CVC during anesthesia for neurosurgery. The patient was successfully resuscitated through prompt recognition of the allergic etiology, immediate catheter removal, and aggressive administration of epinephrine. Subsequent skin prick testing confirmed hypersensitivity to chlorhexidine. This report underscores the importance of considering anaphylaxis in the differential diagnosis of any unexplained perioperative cardiovascular collapse, particularly following the insertion of coated medical devices. Furthermore, we review the relevant literature and provide clinical recommendations for the prevention and management of hypersensitivity reactions associated with antimicrobial CVCs .