左氧氟沙星疑致中毒性表皮坏死松解型药疹1例  

One suspected case of toxic epidermal necrolysis induced by levofl oxacin

作　　者：徐利君[1,2] 李星霞[1] 

机构地区：[1]上海交通大学附属第六人民医院药剂科,上海200233 [2]浙江台州市中心医院药剂科,浙江台州318000

出　　处：《中国药物应用与监测》2015年第4期258-260,共3页Chinese Journal of Drug Application and Monitoring

摘　　要：1例79岁男性患者,因双下肢浮肿、咳嗽咳痰1个月余,加重伴肝功能异常4 d入院。既往有脑出血史,肝功能异常史数年,否认药物、食物过敏史。入院后给予保肝、利尿等对症支持治疗1 d后,双下肢水肿减轻,咳嗽咳痰加重,并出现发热,给予左氧氟沙星(0.5 g,qd,ivgtt)联合头孢哌酮舒巴坦钠(3 g,bid,ivgtt)抗感染治疗,3 d后患者口唇出现大水疱,头面部散在红斑样疹,立即停用左氧氟沙星,之后红斑逐步蔓延至四肢,全身黏膜破溃糜烂,2 d后经皮肤科会诊诊断为中毒性表皮坏死松解型药疹,并给予甲泼尼龙等抗过敏治疗,同时纠正电解质紊乱,加强破损皮肤的护理。之后患者无新发皮疹,皮损创面逐步干燥愈合。One 79-year-old male patient was hospitalized because of edema of both lower extremities, cough and expectoration for more than 1 month, aggravation with hepatic dysfunction for 4 days. The patient described a history of cerebral hemorrhage and liver dysfunction for several years, but denied the history of drugs and food allergies. Hepatoprotective, diuretic and other supportive treatments were given for 1 day after admission, edema of both lower extremities relieved, meanwhile the symptoms of cough and expectoration aggravated accompanying with fever. Levofloxacin （0.5 g, qd, ivgtt） combined with cefoperazone and sulbactam sodium （3 g, bid, ivgtt） were prescribed against infection. After 3 days, several blisters appeared in the patient＇s lips and erythema scattered all over his face, then levofloxacin was stopped immediately. After that the erythema spread to four limbs and the mucosa developed into erosion and peeling, which was diagnosed as toxic epidermal necrolysis by dermatologist two days later. The symptomatic treatments were given in respect of methylprednisolone and other antiallergic remedy, correcting the electrolyte imbalance and strengthening the nursing of damaged skin. Since then, no new rash appeared, and skin wound dried and healed gradually.

关 键 词：左氧氟沙星 中毒性表皮坏死松解型药疹 药品不良反应 

分 类 号：R758.2[医药卫生—皮肤病学与性病学]