左氧氟沙星注射液致中毒性表皮坏死松解症

Toxic epidermal necrolysis due to levofloxacin injection

1例77岁男性患者行经直肠前列腺穿刺活检前为预防感染予左氧氟沙星0.5 g静脉滴注。静脉滴注结束后3 h,患者躯干、臀部、四肢出现红斑伴瘙痒,2 d后出现发热,皮疹加重和大面积水疱;3 d后水疱破溃,尼氏征阳性。诊断:中毒性表皮坏死松解症,考虑与左氧氟沙星有关。给予糖皮质激素联合人免疫球蛋白和皮肤创面处理等对症治疗。15 d后,患者皮疹完全消退,创面基本愈合。

A 77‑year‑old male patient received intravenous infusion of levofloxacin 0.5 g for preventing infection before transrectal prostate biopsy.Three hours after the infusion finished,erythema with pruritus appeared on his trunk,buttocks and limbs.Two days later,the patient developed fever,aggravated rash,and large area of blisters.Three days later,the blisters were broken and Nikolsky sign was positive.Toxic epidermal necrolysis was diagnosed,which was considered to be related to levofloxacin.Symptomatic treatments including combination use of glucocorticoid and human immunoglobulin and skin wound care were given.Fifteen days later,his rash completely subsided and the skin wound healed basically.