Toxic epidermal necrolysis induced by combination of ceftriaxone, lysine acetylsalicylate and Qingkailing（清开灵）
10.3760/cma.j.issn.1008-5734.2019.02.018
- VernacularTitle:头孢曲松与赖氨匹林和清开灵联用致中毒性表皮坏死松解症
- Author:
Jike XIE
1
;
Yongfang HU
;
Xuelian YAN
Author Information
1. 清华大学附属北京清华长庚医院临床药学科/清华大学临床医学院 102218
- Publication Type:Journal Article
- Keywords:
Ceftriaxone;
Anti-inflammatory agents,non-steroidal;
Stevens-Johnson syndrome;
TCM injection
- From:
Adverse Drug Reactions Journal
2019;21(2):150-151
- CountryChina
- Language:Chinese
-
Abstract:
A 30-year-old male patient received Ⅳ infusions of lysine acetylsalicylate 0.9 g dissolved in 0.9％ sodium chloride injection 100 ml,ceftriaxone 4.0 g and dexamethasone 5 mg together dissolved in 0.9％ sodium chloride injection 250 ml,and Qingkailing injection 30 ml dissolved in 5％ glucose injection 250 ml once daily for 2 days in a local clinic for common cold.On day 3 of the drugs withdrawal,the patient developed rash on multiple parts of both hands,accompanied by pruritus.The next day,he developed fever and his body temperature rose to 40 ℃.Over the next few days,the rash gradually spread to his whole body and herpes appeared.Laboratory tests showed that alanine aminotransferase 1 012 U/L,aspartate aminotransferase 413 U/L,total bilirubin 92.5 μ mol/L,and direct bilirubin 72.1 μmol/L.Seven days after the onset of rash,the area of skin lesions,blisters,and exfoliation respectively reached 60％-70％,20％-30％,and ＞ 30％ of his body surface area.The patient was diagnosed with toxic epidermal necrolysis complicated with liver injury.The Ⅳ infusions of methylprednisolone and immunoglobulin and symptomatic support treatments including timely skin care,hepatoprotective drugs,and anti-infection drugs were given,and his skin lesions gradually improved.After 7 days of treatments,methylprednisolone was changed to be taken orally and gradually reduced to discontinuation.Symptomatic treatments such as hepatoprotective therapy lasted for more than 3 weeks.After 40 days,his skin lesions healed.
