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1例50岁男性患者因感冒、发热口服头孢氨苄胶囊0.25g,3次/d和安乃近片0.5g,3次/d治疗,服药后体温降至正常。次日,患者全身皮肤出现红斑、皮疹、瘙痒,继而出现水疱伴灼痛,并再次发热,高达40℃。入院后查体见面部、躯干及四肢有红斑及水疱,皮损面积达体表50%,结膜重度充血。实验室检查:WBC18.9×109/L,N0.78,L0.12,M0.10,ALT74U/L。诊断为中毒性大疱性表皮松解症。立即停用头孢氨苄和安乃近,给予地塞米松、酮替芬,头孢哌酮钠-舒巴坦钠,甘草酸二铵治疗。5d后皮损有所好转,体温降至38.5℃。入院第6天,患者因发热再次服用安乃近0.5g,2次/d,红斑再次加重。立即停药,再行抗过敏等治疗。10d后皮肤症状消褪。
A 50-year-old male patient was treated with oral cefalexin 0.25g, 3 times / d and metamisol 0.5g for 3 times / d due to cold and fever. The body temperature dropped to normal after taking the drug. The next day, erythema, rashes and pruritus appeared on the skin of the patient’s body, followed by blisters with burning pain and fever again, up to 40 ° C. After admission, check the body to see the face, the trunk and limbs with erythema and blisters, skin lesions up to 50% of the body surface, severe congestion of the conjunctiva. Laboratory tests: WBC18.9 × 109 / L, N0.78, L0.12, M0.10, ALT74U / L. Diagnosed as toxic epidermolysis bullosa. Cefalexin and metamizole were discontinued immediately, and dexamethasone, ketotifen, cefoperazone sodium-sulbactam sodium, and diammonium glycyrrhizinate were given. 5d skin lesions have improved, body temperature dropped to 38.5 ℃. On the 6th day after admission, the patient again took metamorphin 0.5g twice daily for fever, and the erythema increased again. Immediate withdrawal, anti-allergy treatment. Skin symptoms fade after 10 days.