克林霉素致重度血小板减少

Clindamycin-induced severe thrombocytopenia

1例3岁男性患儿因溃疡性口炎给予克林霉素0.15 g，1次/d静脉滴注，治疗前血小板计数150×109/L。第1天，患儿左膝关节出现红色瘀斑。第3天，患儿出现齿龈出血及皮肤散在出血点，血小板计数为0，活化部分凝血活酶时间31 s。停用克林霉素，静脉滴注甲泼尼龙（30 mg，1次/d）及人免疫球蛋白（6 g，1次/d），口服氨肽素（0.1 g，3次/d）。第4天，患儿血小板计数64×109/L，活化部分凝血活酶时间16 s，凝血酶原时间11 s。1周后，患儿血小板计数升至135×109/L，瘀斑消退。

A 3-year-old boy received an IV infusion of clindamycin 0. 15 g twice daily for ulcerative stomatitis. Before giving clindamycin,his platelet count was 150 × 109/L. On day 1,the boy presented with red ecchymosis on left knee joint. On day 3,the boy developed gingival bleeding and skin scattered petechiae, his platelet count was 0 and activated partial thromboplastin time was 31 s. Clindamycin was stopped. IV infusions of methylprednisolone（30 mg,once daily）and human immunoglobulin（6 g,once daily）,oral amino-polypeptide（0. 1 g,thrice daily）were given. On day 4,his platelet count was 64 × 109/L,activated partial thromboplastin time was 16 s,prothrombin time was 11 s. After a week,the platelet count returned to 135 ×109/L and ecchymosis disappeared.