Department of General Medicine, Austin Health, Heidelberg, Australia.
J Travel Med. 2014 Nov-Dec;21(6):425-8. doi: 10.1111/jtm.12152. Epub 2014 Aug 28.
We report a case of a 51-year-old Han Chinese recently returned traveler, who was admitted with a generalized maculopapular rash, fevers, shock, and multi-organ failure. Extensive investigations failed to reveal an infective cause. Skin biopsy findings together with the recent commencement of allopurinol raised a diagnosis of drug reaction with eosinophilia and systemic symptom syndrome. High-dose prednisolone was commenced and the patient made a rapid recovery. This case highlights that not all sepsis-like presentations in returned travelers are due to infective causes and that severe drug reactions need to be considered in the differential diagnosis.
我们报告了一例 51 岁的汉族近期归国旅行者，他因全身性斑丘疹、发热、休克和多器官衰竭而入院。广泛的调查未能发现感染原因。皮肤活检结果和最近开始使用别嘌醇提示药物反应伴嗜酸性粒细胞增多和全身症状综合征的诊断。给予大剂量泼尼松龙治疗后，患者迅速康复。本病例提示，并非所有归国旅行者的类似脓毒症表现都与感染有关，严重的药物反应需要在鉴别诊断中考虑。
