<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2448-9190</journal-id>
<journal-title><![CDATA[Revista alergia México]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. alerg. Méx.]]></abbrev-journal-title>
<issn>2448-9190</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Inmunología Clínica y Alergia A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2448-91902018000400431</article-id>
<article-id pub-id-type="doi">10.29262/ram.v65i4.347</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Anafilaxia por clorhexidina en un contexto perioperatorio: diagnóstico y manejo]]></article-title>
<article-title xml:lang="en"><![CDATA[Chlorhexidine anaphylaxis in a perioperative context: diagnosis and management]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Calle]]></surname>
<given-names><![CDATA[Ana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Guevara-Saldaña]]></surname>
<given-names><![CDATA[Liliana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cardona]]></surname>
<given-names><![CDATA[Ricardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Antioquia Grupo de Alergología Clínica y Experimental ]]></institution>
<addr-line><![CDATA[Medellín Colombia]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2018</year>
</pub-date>
<volume>65</volume>
<numero>4</numero>
<fpage>431</fpage>
<lpage>436</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2448-91902018000400431&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2448-91902018000400431&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2448-91902018000400431&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Antecedentes:  Durante una cirugía, el paciente está expuesto a múltiples medicamentos y moléculas que pueden asociarse con el desarrollo de hipersensibilidad, lo que dificulta la detección del agente causal de la reacción perioperatoria y hace necesaria la realización de pruebas guiadas por alergología.  Reporte de caso:  Hombre de 53 años quien posterior a una artroscopia de rodilla derecha se le administró ketorolaco endovenoso; a los 12 minutos se inició brote cutáneo pruriginoso en tórax, abdomen y extremidades; de inmediato se suspendió la infusión del medicamento y se administraron 100 mg de hidrocortisona intravenosa. A los 15 minutos presentó angioedema bilateral de párpados y sensación de disnea, por lo cual se aplicó oxígeno, 2 mg de clemastina intravenosa, 50 mg de ranitidina intravenosa y 20 &#956;g de adrenalina subcutánea. Se realizó prueba epidérmica con clorhexidina a 0.5 % e inmunoglobulina E sérica específica para clorhexidina, ambas con resultados positivos. El paciente se recuperó sin complicaciones; al egreso se le prescribió etofenamato intramuscular.  Conclusión:  La anafilaxia perioperatoria es rara, pero potencialmente fatal. La identificación apropiada del medicamento o sustancia responsable de la reacción por medio de pruebas alergológicas disminuye las restricciones farmacológicas innecesarias y evita la reexposición.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background:  During surgery, the patient is exposed to multiple medications and molecules that can be associated with the development hypersensitivity, which makes it difficult to detect the causative agent of a perioperative reaction and makes it necessary to perform allergy tests.  Case report:  53-year-old man who after a right knee arthroscopy was administered intravenous ketorolac; at 12 minutes, a pruriginous rash appeared on the chest, abdomen and limbs; infusion of the drug was immediately stopped and 100 mg intravenous hydrocortisone were administered. At 15 minutes, the patient experienced bilateral angioedema of the eyelids and a sensation of breathlessness, and oxygen was therefore administered, as well as 2 mg intravenous clemastine, 5 mg intravenous ranitidine and 20 µg subcutaneous adrenaline. Epidermal tests with 0.5 % chlorhexidine and serum chlorhexidine-specific immunoglobulin E (IgE) were performed, both with positive results. The patient recovered without complications; at discharge, he was prescribed intramuscular etofenamate.  Conclusion:  Perioperative anaphylaxis is a rare, but potentially fatal event. Proper identification of the drug or substance responsible for the reaction by using allergy tests decreases unnecessary pharmacological restrictions and avoids re-exposure.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Clorhexidina]]></kwd>
<kwd lng="es"><![CDATA[Anafilaxia]]></kwd>
<kwd lng="es"><![CDATA[Cuidados perioperatorio]]></kwd>
<kwd lng="en"><![CDATA[Chlorhexidine]]></kwd>
<kwd lng="en"><![CDATA[Anaphylaxis]]></kwd>
<kwd lng="en"><![CDATA[Perioperative care]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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