摘要
1例98岁男性患者因肺部感染给予头孢哌酮钠舒巴坦钠、氨溴索等治疗。治疗前患者凝血功能基本正常,血小板计数在参考值范围。因抗感染效果不佳,13 d后将头孢哌酮钠舒巴坦钠改为伏立康唑联合哌拉西林钠他唑巴坦钠,7 d后改为伏立康唑、美罗培南及利奈唑胺葡萄糖注射液;静脉滴注利奈唑胺3 d后患者体温39.3℃,双手、双上肢、肩背部出现散在暗红色瘀点,部分呈片状瘀斑,按之无压痛且不褪色。实验室检查示凝血酶原时间18.4 s,国际标准化比值1.50,活化部分凝血活酶时间53.6 s,纤维蛋白原5.11 g/L,血浆D‑二聚体4.27 mg/L。考虑为过敏性紫癜,可能与利奈唑胺葡萄糖注射液有关。停用该药,换用替加环素,并给予抗过敏、补液和输注血浆等治疗,其他治疗不变。11 d后,患者皮肤瘀点瘀斑消失,实验室检查示凝血酶原时间16.2 s,国际标准化比值1.28,活化部分凝血活酶时间35.6 s,纤维蛋白原2.62 g/L,血浆D‑二聚体2.48 mg/L。
A 98‑year‑old male patient received cefoperazone sodium and sulbactam sodium and ambroxol etc.due to pulmonary infection.Before treatments,the patient′s coagulation function was basically normal,and the platelet count was within the reference range.Due to poor anti‑infection effect,cefoperazone sodium and sulbactam sodium was changed to voriconazole combined with piperacillin sodium and tazobactam sodium 13 days later,which was adjusted to voriconazole,meropenem and linezolid glucose injection 7 days later.Three days after linezolid administration,the patient′s temperature was 39.3℃,and scattered dark red petechiae appeared on his both hands,upper limbs,shoulders and back,with some appearing as patchy ecchymosis,without tenderness pain and fading when pressing.Laboratory tests showed that prothrombin time was 18.4 s,international normalized ratio was 1.50,activated partial thromboplastin time was 53.6 s,fibrinogen was 5.11 g/L,and plasma D‑dimer was 4.27 mg/L.It was considered to be allergic purpura,which might be related to linezolid glucose injection.The drug was stopped and replaced by tigecycline,and the treatment such as anti‑allergy,fluid replacement,and plasma infusion were given.Eleven days later,the patient′s skin petechiae and ecchymosis disappeared.Laboratory tests showed prothrombin time 16.2 s,international normalized ratio 1.28,activated partial thromboplastin time 35.6 s,fibrinogen 2.62 g/L,and plasma D‑dimer 2.48 mg/L.
作者
陈妍
杨申申
王子民
王伟华
Chen Yan;Yang Shenshen;Wang Zimin;Wang Weihua(Department of Geriatrics,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)
出处
《药物不良反应杂志》
CSCD
2023年第6期379-381,共3页
Adverse Drug Reactions Journal
关键词
紫癜
过敏性
药物相关副作用和不良反应
利奈唑胺
Purpura,Schoenlein‑Henoch
Drug‑related side effects and adverse reactions
Linezolid
作者简介
通信作者:陈妍,Email:cy19820824@126.com。
