摘要
1例66岁男性患者因经皮肝穿刺胆道引流术后出现肺部感染，给予头孢地嗪2 g静脉滴注、1次/12 h。治疗12 d后好转，改为头孢克洛混悬液0.25 g口服、1次/8 h。2 d后患者胸背部及双下肢出现红色丘疹，无瘙痒，考虑为头孢克洛引起的药疹，停用该药并肌内注射盐酸异丙嗪12.5 mg红色丘疹消退。停药8 d后，患者行剖腹探查术＋肝门部占位活检术，术后再次应用头孢地嗪（2 g静脉滴注、1次/12 h）抗感染，并给予预防应激性溃疡、镇痛、护肝等综合支持治疗。术后第3天，患者出现皮肤瘙痒，口唇有疱疹，颜面部及躯干发红，稍有肿胀，皮肤温度高，有少许皮屑，口腔、外阴等部位可见糜烂面伴渗出。考虑为头孢地嗪引起的剥脱性皮炎，立即停用所有药物，给予甲泼尼龙（40 mg，1次/d）和复方甘草酸苷注射液（60 ml，1次/d）静脉滴注，氯雷他定（10 mg，1次/d）口服，炉甘石洗剂外用，碳酸氢钠漱口。用药2 d 后患者全身开始脱皮，症状逐渐好转，16 d后患者皮炎症状基本痊愈。
A 66-year-old male patient with obstructive jaundice by percutaneous transhepatic cholangial drainage operation, pulmonary infection was found 15 days later, An IV infusion of cefodizime 2 g once every 12 hours was given for about 12 d and then was shifted to oral cefaclor suspension liquid 0.25 g once every 8 hours. Two days after drug administration, he developed red papules on chest, back and both lower limbs, without itching, adverse reactions induced by cefaclor were considered. The red papules subsided after cefaclor was stopped and intramuscular injection of promethazine hydrochloride 12.5 mg was given. Eight days after stopping cefaclor, the patient underwent an operation which was ＂explorative laparotomy and hepatic hilar biopsy for a space-occupying lesion＂ under general anesthesia. An IV infusion of cefodizime 2 g once every 12 hours was given again for antiinfection, and comprehensive support treatment for prevention of stress ulcer, analgesia, liver protection drugs were given. Three days later, the patient developed skin itching, herpes on lips, facial and torso redness, slight swelling, high skin temperature, a little damder, and erosion on mouth, genital and other parts of the body could be seen with exudation. Exfoliative dermatitis induced by cefodizime was considered. Then all drugs were immediately stopped, IV infusion of methylprednisolone 40 mg, once daily, compound glycyrrhizin injection 60 ml, once daily; oral loratadine 10 mg, once daily; topical use calamine lotion; sodium bicarbonate mouthwash. Two days after administration of the drugs, the patient began to have desquamation, 7 days later the symptoms of exfoliative dermatitis had mitigated, the symptoms of infection gradually improved without using any other anti-infective drugs. Sixteen days later, the symptoms got improved and no symptoms recurred.
出处
《药物不良反应杂志》
CSCD
2018年第1期65-66,共2页
Adverse Drug Reactions Journal
关键词
头孢菌素类
药物过敏
皮炎
剥脱性
Cephalosporins
Drug hypersensitivity
Dermatitis, exfoliative
