氟康唑注射液致严重过敏反应1例

One case of serious anaphylaxis induced by fluconazole injection

1例45岁男性患者,因确诊肺癌入院,此次化疗同时行颅脑放疗。患者咽拭子及大便中检出真菌,给予氟康唑注射液(100 mg,ivgtt)抗真菌治疗。在输注结束2 min后,患者出现寒战、高热、喘憋、剧烈咳嗽等症状,考虑为严重过敏反应,立即给予持续吸氧(4 L·min-1),地塞米松磷酸钠注射液(5 mg,iv)、盐酸苯海拉明注射液(1 m L,im)、二羟丙茶碱注射液(0.25 g,ivgtt)、注射用甲泼尼龙琥珀酸钠(40 mg,iv)、注射用赖氨匹林(0.9 g,iv)等对症治疗。之后患者症状逐渐缓解,3 h后症状消失。

One 45-year-old male patient diagnosed with lung cancer received chemotherapy and radiotherapy. Throat swab culture and stool culture conifrmed fungal infections and lfuconazole injection （100 mg, ivgtt） was given for antifungal therapy. Two minutes after the end of infusion, the patient complained of shiver, hyperpyrexia, suffocation and severe cough, which was considered as severe allergic reaction. Inhalation of oxygen （4 L·min^-1）, dexamethasone sodium phosphate injection （5 mg, iv）, diphenhydramine hydrochloride injection （1 mL, im）, diprophylline injection （0.25 g, ivgtt）, methylprednisolone sodium succinate for injection（40 mg, iv） and lysine acetylsalicylate for injection （0.9 g, iv） were given. Then the patient recovered gradually and the above symptoms disappeared 3 h later.