乙胺丁醇引发哮喘样症状

Asthma-like symptom attributed to ethambutol

1名65岁男性患者,于淋巴结结核手术后,给予异烟肼0.3g/d、利福平0.45g/d、吡嗪酰胺0.5g,2次/d、乙胺丁醇片0.75g/d。用药18d后患者出现畏寒、乏力、咳嗽、胸闷,服用对乙酰氨基酚、阿莫西林。次日患者咳嗽加剧,并出现发热(T38℃),呼吸困难,不能平卧,口唇发绀,双肺哮鸣音,对症处理后缓解。停用抗结核药物,哮喘样症状消失。1周后,给予患者异烟肼,之后每3d分别加用利福平和吡嗪酰胺,未出现哮喘样症状。但当加服乙胺丁醇后数小时内再次出现哮喘样症状。

A 65-year-old man started receiving antituberculous treatment with isoniazide 0.3 g/d, rifampin 0.45 g/d, pyramide 0.5 g twice daily, and ethambutol 0.75 g/d after the operation of lymphoid tuberculosis. After 18 days of treatment, he developed chilly, hypodynamia, cough, and chest distress. He was treated with paracetamol and amoxicillin. The next day, his cough was aggravated and followed a fever （T 38℃）, dyspnea, inability to lie flat, cyanosis of the lips, wheezing in the lungs. After symptomatic therapy, he relieved. After discontinuation of the antituberculous drugs, the asthma-like symptom disappeared. One week later, isoniazide was given to the patient at first, then, rifampin and pyramide were added respectively to his regimen every three days. The asthma-like symptom did not appear. But within several hours after addition of ethambutol, the asthma-like symptom reappeared.