头孢地嗪钠致大疱性表皮松解型药疹

Cefodizime sodium-induced epidermolysis bullosa

1例80岁男性患者,因肺部感染给予头孢地嗪钠1.5g加入0.9%氯化钠注射液250ml静脉滴注。输注约10ml时,患者出现心慌、胸闷、畏寒、全身皮肤瘙痒、高热。体格检查示体温39.6℃,全身皮肤片状发红,四肢处明显。立即停止输液并行对症支持治疗后,患者心慌、畏寒症状消失,体温下降,但皮肤症状未见好转。次日背部、四肢出现多个松弛状水疱,之后发展成糜烂面。考虑皮肤症状为头孢地嗪钠所致。加用氢化可的松、氯苯那敏等抗过敏治疗,同时改为夫西地酸静脉滴注抗感染治疗。之后肺部感染和皮肤症状均痊愈。

An 80-year-old male patlen! received an IV infusion of cefodizime sodium 1.5 g dissolved in 0.9% sodium chloride 250 ml for pulmonary infections. While receivang about 10 ml of the infusion, the patient developed palpitation, chest distress, cold intolerance, generalized pruritus, and high fever. Physical examinations showed a temperature of 39.6℃, red lamella appearing on generalized skin, especially on his limbs. The infusion was discontinued immediately and he received symptomatic treatment and supportive therapy. Then palpitation and cold intolerance were subsided and his temperature decreased. However, his skin symptoms did not improve. The next day, some flaccid vesicles appeared on his back and limbs, which later progressed to erosion. Skin symptoms due to cefodizime sodium were considered and the drug was not readministered. He received hydrocortisone, chlorphenamine, and other anti-allergic therapy. Meanwhile, fusidic acid was given for anti-infection. Subsequently, his skin symptoms and pulmonary infections improved gradually.