摘要
1例63岁老年女性患者,因确诊“幽门螺杆菌感染”首次服用阿莫西林胶囊、克拉霉素分散片、复方铝酸铋颗粒及兰索拉唑胶囊治疗,在门诊进行阿莫西林皮试,结果为阴性。服药3d后面部、眼睑明显肿胀,全身多处皮肤潮红,皮疹范围约占全身70%,可见少量水疱破裂,伴有高热,视物模糊。实验室检查血常规示:外周白细胞计数15.0×109·L-1,中性粒细胞计数92.31%,淋巴细胞百分率5.10%,C-反应蛋白166.28mg·L-1,诊断为“重症多形红斑药疹”。立即停止所有可疑药物,静脉滴注甲泼尼龙琥珀酸钠、人免疫球蛋白,并外用炉甘石洗剂于四肢及躯干,夫西地酸乳膏外用于面部。治疗3d后,患者体温恢复至正常,潮红肿胀明显消退,疼痛瘙痒消失,停用人免疫球蛋白,甲泼尼龙琥珀酸钠逐渐减量。后续皮疹情况持续改善,出院后口服醋酸泼尼松片。一周后复诊,皮疹全部消失。
A 63-year-old woman diagnosed as helicobacter pylori infection was first treated with amoxicillin capsules, clarithromycin dispersible tablets, compound bismuth aluminate granules and lansoprazole capsules. The skin test of amoxicillin was negative. After three days, her face and eyes were significantly swollen and many parts of the body were flushed. 70% of the body was covered by rashes and few blisters were broken. The patient also developed high fever and blurred vision. Results of laboratory examination showed that the count of blood white blood cells was 15.0 × 10^9·L^-1, the count ratio of neutrophils was 92.31%, the count ratio of lymphocytes was 5.10%, C-reactive protein was 166.28 mg·L^-1. The patient was diagnosed as severe drug eruption. All suspicious drugs were immediately stopped and successively treatment including intravenous drip of methylprednisolone sodium succinate and human immunoglobulin, external application of calamine lotion on the limbs and trunk and fusidic acid on the face. 3 days later, the flushing and swelling was significantly subsided and the body temperature returned to normal. And then human immunoglobulin was stopped and the dose of methylprednisolone sodium succinate was gradually reduced. The follow-up rash situation continued to improve and the patient was discharged with oral prednisone acetate tablets. A week later, the rash was wholly disappeared.
作者
孙文芳
王慧英
张晓兰
刘宪军
SUN Wen-fang;WANG Hui-ying;ZHANG Xiao-lan;LIU Xian-jun(Department of Pharmacy, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China)
出处
《中国药物应用与监测》
CAS
2019年第3期183-185,共3页
Chinese Journal of Drug Application and Monitoring
基金
北京市科技计划课题(Z181100001718144)
北京市通州区科技计划项目(KJ2018CX009)
通州区卫生发展科研专项项目任务书(TF-2017-PT-01-47)
关键词
阿莫西林
重症多形红斑药疹
药品不良反应
Amoxicillin
Severe polymorphic erythematous eruption
Adverse drug reaction
