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Taurolidine-induced Severe Anaphylaxis

Horvath LC, Heinz G, Bangert C, Jorda A, Staudacher M, Gelbenegger G, Jilma B

Kidney medicine, 2025

Abstract

Taurolidine-based catheter lock solutions are widely used for central venous catheters. Although minor infusion-related symptoms and allergic reactions have been documented, no systemic effects or severe cases of anaphylaxis have been observed. Here, we detail a case of taurolidine-induced life-threatening anaphylaxis. We report the case of a 59-year-old man who had a severe anaphylactic reaction to taurolidine following accidental intravenous infusion, which required treatment in the intensive care unit. Anaphylactic shock, which was resistant to conventional treatment with epinephrine, required additional management with norepinephrine and vasopressin. After the resolution of the anaphylactic episode, the patient was discharged from the intensive care unit. An outpatient allergy work-up using a skin prick test was performed, which confirmed a suspected allergy to taurolidine. In conclusion, taurolidine induced a severe, prolonged anaphylactic shock that did not respond to conventional treatment with intravenous and inhaled epinephrine, antihistamines, glucocorticoids, or continuous norepinephrine infusion. New treatment strategies for refractory anaphylactic shock are needed.

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