Brucculeri Michael, Charlton Marian, Serur David
Division of Nephrology and Hypertension, New York Presbyterian Hospital - Weill Medical College of Cornell University, 525 East 68th Street, New York, NY 10021, USA.
The Rogosin Institute, New York Presbyterian Hospital - Weill Medical College of Cornell University, 525 East 68th Street, New York, NY 10021, USA.
BMC Clin Pharmacol. 2006 Feb 23;6:3. doi: 10.1186/1472-6904-6-3.
Although rare, serum sickness-like reactions have been documented to occur following the administration of many antibiotics. Cefazolin, a first generation cephalosporin, is a commonly prescribed antibiotic which is considered to be generally safe and well tolerated. There have been no prior reports linking this drug with sickness-like reactions. We report a probable case of serum sickness-like reaction following a single dose of cefazolin.
A 23 year old man with no significant past medical history was admitted to undergo a laparoscopic donor nephrectomy as part of a living-related renal transplant. One gram of intravenous cefazolin was administered perioperatively. The surgery was completed without complication and the remainder of his hospital course was uneventful. Ten days following discharge the patient developed fevers, painful and swollen joints, and a cutaneous eruption overlying his trunk and extremities. There was no evidence of systemic vasculitis. These clinical findings were most consistent with a serum sickness-like reaction. A brief course of corticosteroids and antihistaminergic therapy was initiated, and complete resolution of the patient's symptoms followed. The Naranjo probability scale indicated that this adverse drug event was probable.
Serum sickness-like reaction may be associated with cefazolin therapy.
虽然血清病样反应罕见，但已有文献记载在使用多种抗生素后会发生。头孢唑林是第一代头孢菌素，是一种常用的抗生素，一般认为其安全性好且耐受性佳。此前尚无该药物与病样反应相关的报道。我们报告了一例单剂量头孢唑林治疗后可能发生血清病样反应的病例。
一名既往无重大病史的23岁男性因活体亲属肾移植行腹腔镜供体肾切除术入院。术中静脉注射1克头孢唑林。手术顺利完成，术后住院过程平稳。出院十天后，患者出现发热、关节疼痛肿胀以及躯干和四肢皮肤疹。无系统性血管炎证据。这些临床表现最符合血清病样反应。开始短期使用皮质类固醇和抗组胺治疗，患者症状完全缓解。Naranjo概率量表显示该药物不良事件很可能发生。
血清病样反应可能与头孢唑林治疗有关。
