高浓度两性霉素B溶液膀胱冲洗致药物热

Drug fever due to bladder irrigation with high concentration of amphotericin B solution

1例92岁男性患者因热带念珠菌泌尿系感染予两性霉素B 25 mg入灭菌注射用水250 ml膀胱冲洗,1次/d。用药第3~5天,患者每日16时左右发热,体温最高38.0℃;第5天实验室检查示白细胞计数(WBC)7.2×10^9/L,中性粒细胞0.67,嗜酸粒细胞0.015,C反应蛋白0.18 mg/L。考虑可能是两性霉素B膀胱冲洗引起的药物热,停用该药。停药后24 h,患者体温降至37.6℃;48 h,患者体温恢复正常,实验室检查示WBC 6.2×10^9/L,中性粒细胞0.66,嗜酸粒细胞0.034。

A 92-year-old male patient received bladder irrigation with amphotericin B 25 mg dissolved in sterilized water for injection 250 ml once daily for Candida tropicalis urinary system infection.On day 3 to 5 of the treatment,the patient had a fever around 16:00 every day and the temperature was up to 38.0℃.On day 5,laboratory tests showed white blood cell(WBC)7.2×10^9/L,neutrophil 0.67,eosinophils 0.015,and C-reactive protein 0.18 mg/L.Drug fever due to bladder irrigation with amphotericin B was considered.Amphotericin B was stopped.Twenty-four hours after the drug withdrawal,his body temperature decreased to 37.6℃.Forty-eight hours after the drug withdrawal,his body temperature returned to normal.Laboratory tests showed WBC 6.2×10^9/L,neutrophil 0.66,and eosinophils 0.034.