1例替加环素致皮疹伴嗜酸粒细胞增多报道

A case skin rash with eosinophilia caused by tigecycline

1例59岁男性因腹主动脉支架植入和右肾动脉支架植入术后肺部感染,根据病原学回报结果给予替加环素(首次剂量100 mg,随后50 mg,每12小时1次,静脉滴注)抗感染治疗。用药第8天,患者双下肢出现散在大小不等红色斑疹,界限欠清楚,形态欠规则,表面光滑干燥,局部融合成片,压之褪色。次日皮疹较前明显加重,范围扩大遍及全身,无破溃。自应用替加环素至皮疹发生,患者嗜酸性粒细胞计数始终高于正常值,波动在1.03×109·L-1至1.27×109·L-1之间。对其用药进行梳理分析,考虑替加环素引起的过敏反应,遂予以停用替加环素并进行抗过敏治疗。随后患者皮疹明显减轻至痊愈,同时嗜酸性粒细胞逐渐下降恢复至正常。因此,临床应用替加环素时应高度警惕皮疹的发生,确保安全用药。

Based on result of pathogenic detection,a 59-year-old male patient was prescribed tigecycline(100 mg for the first time,then 50 mg for every 12 hours,ivgtt)for lung infection after abdominal aortuc implantation and right renal artery stent implantation.On the 8th day,varying sizes of red flat rashes with unclear boundary and irregularly shape showed on both lower extremities.The surface of them was smooth and dry,some parts appear confluent and could be fade if the pressure putted on.The rash was significantly worse than before on the next day,and the skin spread all over the body without rupture.The eosinophil count was beyond the normal as ranging from 1.03×109·L-1 to 1.27×109·L-1 since tigecycline administration.Based on the medication evaluation,tigecycline was suspected as the reason of allergic response.The patient’s rash gradually improved to recovery after tigecycline was withdrawn and anti-allergic treatment was taken.Meanwhile,the eosinophil count decreased to a normal level.Hence more attention should be paid to skin rash induced by tigecycline for ensuring the safety drug use in practice.