注射用头孢曲松钠致大疱性表皮坏死松解型药疹

Bullous epidermal necrolysis drug eruption caused by ceftriaxone sodium for injection

1例71岁急性脑干梗死男性患者因出现肺部感染,给予注射用头孢曲松钠3g入0.9%氯化钠注射液100ml静脉滴注。滴注结束后约3h,患者出现手足红肿、全身多处皮肤泛红伴皮疹;滴注结束后约6h,患者手部、大腿根部及会阴部多发大疱样水泡。考虑可能为注射用头孢曲松钠所致大疱性表皮坏死松解型药疹。改用莫西沙星抗感染,治疗脑梗死的药物继续应用,并给予抗过敏、皮损处局部用药、皮肤破溃处可见光治疗等对症支持治疗,5d后患者全身皮疹消退。

A 71-year-old male patient with acute brain stem infarction received an IV infusion of ceftriaxone sodium for injection 3 g,dissolved in 0.9% sodium chloride injection 100 ml,for later pulmonary infection.About 3 hours after completing the infusion,the patient developed red swelling on the hands and feet,and skin redness and rash on multiple parts of the body.About 6 hours after completing the infusion,he developed multiple vesiculobullous on the hands,thighs root and perineum.Bullous epidermal necrolysis drug eruption induced by ceftriaxone sodium for injection was considered.The anti-infective drug was changed to be moxifloxacin and drugs for brain infarction were continued.At the meantime,the patient was given symptomatic supportive treatments such as anti-allergy,topical medication in skin lesions,and visible light treatment at skin ulceration.Five days later,the whole rash subsided.