头孢他啶注射液致哮喘样呼吸困难及过敏性休克1例

One case report of dyspnea like asthma and anaphylactic shock caused by ceftazidime injection

1例42a可疑系统性红斑狼疮女性患者,在糖皮质激素冲击治疗期间因出现上呼吸道感染、手背疱疹,给予头孢他啶注射液2.0g,bid,ivgtt,克林霉素0.6g,bid,ivgtt及阿昔洛韦0.25g,tid,ivgtt。5h后出现一过性呼吸困难,经对症治疗后症状缓解。次日上午输完头孢他啶后约半小时出现急性呼吸困难,全身皮肤湿冷,双肺闻及广泛湿啰音及哮鸣音,经皮血氧饱和度监测降至85%,BP85/60mmHg。经吸氧、抗过敏、平喘、扩容、呼吸机辅助通气后约2h症状缓解,当日下午出现口唇水肿伴全身多形性红斑。第3次在输注头孢他啶约15min时,再次出现急性呼吸困难,停药后未再出现类似症状。

A 42-year-old female patient with suspected systemic lupus erythematosus was treated with an intravenous infusion of ceftazidime 2.0 g twice daily, clindamycin 0.6 g twice daily and acyclovir 0.25 g thrice daily for upper respiratory tract infection and herpes on the back of the hand during glucocorticosteroid pulse therapy. Five hours later, she suffered from transient dyspnea, which was relieved with symptomatic treatment. The next morning, she abruptly developed dyspnea again half an hour after the infusion of ceftazidime. Skin cold clammy could be observed, rales and wheezes were heard in both lung fields, the blood oxygen saturation was 85% and the blood pressure decreased to 85/60 mmHg. The symptoms improved two hours after the therapies of oxygen inhalation, antianaphylaxis, bronchodilators, transfusion and mechanical ventilation. Then she developed edema on the mouth and lip with erythema multiforme on the total body in the afternoon. The symptom of dyspnea reappeared just 15 minutes after the third time intravenous infusion of ceftazidime,and the symptoms disappeared after withdrawl of ceftazidime.