左氧氟沙星、头孢哌酮钠舒巴坦钠与克林霉素相关大疱性表皮松解症

Epidermolysis bullosa after treatment with levofloxacin,cefoperazone sodium and sulbactam sodium,clindamycin

1例62岁女性患者因泌尿系统感染给予左氧氟沙星0.5 g,1次/d静脉滴注。当日患者双上肢内侧和背部出现红色皮疹,停药并接受抗过敏治疗。第2天因肺部感染给予头孢哌酮钠舒巴坦钠4.0 g,1次/8 h静脉滴注,克林霉素0.75 g,1次/d静脉滴注。6 d后患者口腔黏膜出现糜烂,全身多处可见弥漫性红肿和松弛性水疱,部分表皮剥脱,诊断为大疱性表皮松解症。停用抗菌药物并给予甲泼尼龙80 mg,1次/d静脉滴注,3 d后皮肤症状减轻。次日因皮肤继发感染给予硫酸阿米卡星0.4 g,1次/8 h静脉滴注,当天再次出现皮疹。经糖皮质激素联合人免疫球蛋白及支持治疗,皮肤症状逐渐好转。

A 62-year-old female patient received an IV infusion of levofloxacin 0.5 g once daily for urinary tract infection, red rash developed on inner side of her upper limbs and back on the same day. The levofloxaein was discontinued and anti-allergic treatments were given. The next day, she received an IV infusion of cefoperazone sodium and sulbactam sodium 4.0 g every 8 hours and elindamycin 0.75 g once daily for pulmonary infection. After six days, she experienced oral mucosal erosion, diffused red swelling and flaccid vesicles appeared on her multiple body regions, and partial exfoliation occurred. Epidermolysis bullosa was diagnosed. Antibiotics were discontinued and an IV infusion of methylprednisolone 80 mg once daily was given. Her skin symptoms relieved after 3 days. The next day, she received an IV infusion of amikacin sulfate 0.4 g every 8 hours for a secondary infection of the skin. The rash appeared again on the same day. Glucocorticoid combined human immunoglobulin and supportive treatments were given. Her symptoms of skin gradually improved.