克林霉素静脉滴注致剥脱性皮炎

Exfoliative dermatitis following an intravenous infusion of clindamycin

1例69岁男性患者,眼部手术后给予克林霉素0.6 g加入0.9%氯化钠注射液500 mL静脉滴注预防感染。给药20 min时患者出现胸、腹部皮肤瘙痒、疼痛,随后发展为红色斑丘疹。诊断为克林霉素致剥脱性皮炎,立即停药。给予10%葡萄糖酸钙注射液10 mL、维生素C注射液3.0 g加入5%葡萄糖注射液250 mL静脉滴注;地塞米松注射液10 mg加入莫菲滴管1次/d;氯雷他定10 mg,1次/d口服。第2天患者胸腹部、大腿根皮肤呈点片状脱屑,第3天胸腹部表皮出现大面积脱落。治疗10 d后患者皮损痊愈,出院。

A 69-year-old man received an I V infusion of clindamycin 0.6 g dissolved in 0.9% sodium chloride 250 mL for prevention of infections following ocular surgery.Twenty minutes later,the patient developed itching and aches in his chest and abdomen,followed by red maculopapu lareruption.Clindamycin-induced exfoliative dermatitis was diagnosed and the drug was discontinued.The patient was given an IV infusion of 10% calcium gluconate 10 mL and vitamin C 3.0 g added to 5% glucose 250 mL;he was also receiving dexamethasone 10 mg once daily via a Murphy＇s dropper and oral loratadine 10 mg once daily.On day 2,furfuraceous skin desquamation occurred on his chest,abdomen,and upper thigh and,on day 3,large areas of exfoliation appeared on his chest and abdomen.After 10 days of treatment,the patient＇s skin lesion resolved and he was discharged.