摘要
1例57岁女性患者因阴道炎给予口服硝呋太尔片（0．4g，3次／d）和硝呋太尔阴道片（250mg，每晚1片）局部外用。用药第14天患者出现全身红色皮疹伴瘙痒，实验室检查示外周血WBC7．8×10^9／L，中性粒细胞0．70，淋巴细胞0．20，嗜酸粒细胞0．006，PLT185×10^9／L，ESR54mm／1h。诊断为变态反应性皮炎，给予苯海拉明20mg肌内注射，氯雷他定（10mg，1次／d）和西替利嗪（10mg，1次／d）口服，硝呋太尔继续应用。用药第16天患者出现发热，皮疹继续加重，面部及全身均可见皮疹，皮疹面积、数量增加。用药第18天患者躯干、上肢出现暗红色皮疹，双下肢出现大片暗红瘀斑，实验室检查示ESR为68mm／1h。诊断为过敏性紫癜伴感染。停用硝呋太尔片、硝呋太尔阴道片、氯雷他定和西替利嗪，给予阿奇霉素（0．5g，1次／d）和甲泼尼龙（80mg，1次／d）静脉滴注。停用硝呋太尔第3天，患者皮疹部分？肖退，改为口服阿奇霉素（0．5g，1次／d）和泼尼松（10mg，1次／d）；第6天，皮疹基本消退，停用阿奇霉素，泼尼松减量为5mg、1次／d；第10天，皮疹完全消退，停用泼尼松。
A 57-year-old female with vaginitis received oral nifuratel 0.4 g thrice daily and nifuratel vaginal tablets 250 mg once every night for topical use. After 13 days of treatment, the patient developed red rashes on generalized skin with itching. Laboratory tests showed the following values： white blood cell （WBC） count 7.8× 10^9/L, neutrophil 0.70, lymphocytes 0. 20, eosinophil 0. 006, platelet （PLT） 185× 10^9/L, and erythrocyte sedimentation rate （ESR）54 mm/1 h. She was given IM injection of diphenhydramine 20 mg, oral loratadine 10 mg and cetirizine 10 mg once daily. But the patient＇s symptoms were not improved and her rashes exacerbated and accompanied by fever, her rashes can be seen on both face and body shin accompanied with rashes area and number increasing. Three days later, the patient developed edematous erythema on her trunk and upper limbs, a large pieces of dark red eeehymosis on her both lower limbs. Laboratory test showed ESR was 68 mm/1 h. The patient was diagnosed as anaphylactoid purpura with infection. Nifuratel, loratadine, and cetirizine were stopped and IV infusion of azithromycin 0.5 g and methylprednisolone 80 mg once daily were given. After 2 days of treatments, the rashes partly disappeared, azithromyein 0.5 g and prednisone 5 mg once daily were given by mouth and 3 days later, the rashes disappeared. Azithromycin was stopped and oral prednisone 5 mg once daily was given . After 4 days of treatment, the rashes completely disappeared. Prednisone was stopped.
出处
《药物不良反应杂志》
CSCD
2016年第2期138-140,共3页
Adverse Drug Reactions Journal
关键词
硝呋太尔
紫癜
过敏性
Nifuratel
Purpura, Schoenlein-Henoch
