Rajabally Hanaa, Nageshwaran Sathiji, Russell Sabina
Department of General Medicine, Chase Farm Hospital, Middlesex, UK.
BMJ Case Rep. 2012 Jul 9;2012:bcr0120125653. doi: 10.1136/bcr.01.2012.5653.
A 73-year-old man presented in status epilepticus. He had a long history of epilepsy for which he was treated with regular phenytoin and phenobarbitone. On admission, his phenytoin level was found to be subtherapeutic and was treated with rectal diazepam and intravenous lorazepam. He was later started on an infusion of phenytoin in preparation to restart his oral medication. The medication was delivered via a peripheral cannula in his forearm. Five days later, he developed redness and swelling of this arm followed by the appearance of a large ulcer. After ruling out infective causes and a compartment syndrome it was felt that the patient had developed a delayed purple glove syndrome secondary to intravenous phenytoin. Following 7 days of regular saline irrigation and dressing changes, the erythema improved and the ulcer showed signs of healing, and eventually resolved.
一名73岁男性出现癫痫持续状态。他有长期癫痫病史，一直使用苯妥英和苯巴比妥进行常规治疗。入院时，发现他的苯妥英水平低于治疗剂量，遂给予直肠用安定和静脉注射劳拉西泮治疗。后来开始静脉输注苯妥英，为重新开始口服药物做准备。药物通过他前臂的外周静脉留置针输注。五天后，他的手臂出现红肿，随后出现一个大溃疡。在排除感染原因和骨筋膜室综合征后，认为患者发生了静脉注射苯妥英继发的迟发性紫手套综合征。经过7天的生理盐水冲洗和换药，红斑有所改善，溃疡显示出愈合迹象，最终痊愈。
