Song E K, Seon J K, Jeong M S
Department of Orthopaedic Surgery, Center for Joint Disease, Chonnam National University, Hwasun Hospital, 160 Ilsimri, Hwasun-eup, Hwasun-gun, Jeonnam 519-809, South Korea.
J Bone Joint Surg Br. 2010 Nov;92(11):1596-9. doi: 10.1302/0301-620X.92B11.24827.
We describe a patient who developed a delayed-type hypersensitivity reaction to piperacillin/tazobactam in the cement beads and a spacer inserted at revision of total replacement of the left knee. We believe that this is the first report of such a problem. Our experience suggests that a delayed-type hypersensitivity reaction should be considered when a mixture of antibiotics such as piperacillin/tazobactam has been used in the bone cement, beads or spacer and the patient develops delayed symptoms of pain or painful paraesthesiae, fever, rash and abnormal laboratory findings in the absence of infection. The diagnosis was made when identical symptoms were induced by a provocation challenge test.
我们描述了一名患者，其在左膝关节全置换翻修时植入的骨水泥珠及间隔物中对哌拉西林/他唑巴坦发生了迟发型超敏反应。我们认为这是此类问题的首例报告。我们的经验表明，当骨水泥、骨水泥珠或间隔物中使用了如哌拉西林/他唑巴坦等抗生素混合物，且患者在无感染的情况下出现疼痛或疼痛性感觉异常、发热、皮疹及实验室检查异常等延迟症状时，应考虑迟发型超敏反应。当激发试验诱发相同症状时即可做出诊断。
