摘要
1例50岁男性患者因感冒、发热口服头孢氨苄胶囊0.25g,3次/d和安乃近片0.5g,3次/d治疗,服药后体温降至正常。次日,患者全身皮肤出现红斑、皮疹、瘙痒,继而出现水疱伴灼痛,并再次发热,高达40℃。入院后查体见面部、躯干及四肢有红斑及水疱,皮损面积达体表50%,结膜重度充血。实验室检查:WBC18.9×109/L,N0.78,L0.12,M0.10,ALT74U/L。诊断为中毒性大疱性表皮松解症。立即停用头孢氨苄和安乃近,给予地塞米松、酮替芬,头孢哌酮钠-舒巴坦钠,甘草酸二铵治疗。5d后皮损有所好转,体温降至38.5℃。入院第6天,患者因发热再次服用安乃近0.5g,2次/d,红斑再次加重。立即停药,再行抗过敏等治疗。10d后皮肤症状消褪。
A 50-year-old man with a cold and fever received cefalexin 0.25 g capsules thrice daily and metamizole sodium 0.5 g tablets thrice daily. His temperature returned to normal after administration. The next day, the man developed erythema, skin rash with pruritus over his entire body, followed by blister with burning pain. His temperature increased again, and peaked at 40℃. After hospitalization, physical examination showed erythema and blister on his face, trunk, and extremities, damaged skin involving 50% of his body surface area, severe conjunctive congestion. Laboratory examination revealed the following values： WBC 18.9 × 10^9/L, N 0. 78,L 0.12,M 0.10 and ALT 74 U/L. He was diagnosed with toxic bullosa epidermalysis＋ Cefalexin and metamizole sodium were discontinued immediately. He was treated with dexamethasone, ketotifen, cefoperazone sodium-sulbactam sodium, diammonium glycyrrhizinate. His damaged skin improved to some extent and his temperature decreased to 38.5℃. On day 6 after admission, the patient restarted receiving metamizole sodium 0.5 g tablets twice daily for a fever. His erythema became aggravated. The medication was withdrawn immediately. Antianaphylactic therapy was given again. Ten days later, his skin symptoms subsided.
出处
《药物不良反应杂志》
2009年第1期39-39,46,共2页
Adverse Drug Reactions Journal
