弥漫性皮疹，精神状态改变·诊断为何？

Diffuse skin rash, altered mental status · Dx?

作者信息

Reed Caitlyn T, Cruse Allison R, Jackson Jeremy D

机构信息

University of Mississippi Medical Center, Department of Dermatology, Jackson, MS, USA. Email:

University of Mississippi Medical Center, Department of Dermatology, Jackson, MS, USA.

出版信息

J Fam Pract. 2017 Nov;66(11):E7-E9.

PMID:29099518

Abstract

A 74-YEAR-OLD CAUCASIAN MAN presented to the hospital with intractable back and chest pain, a diffuse skin rash, and altered mental status. He said that 2 days ago, he'd gone to a different local hospital for treatment of back pain and a headache that had begun 3 days earlier. He was treated with intravenous hydromorphone and sent home with a prescription for meperidine. He said that several hours after being treated with the hydromorphone, the rash developed on his head and then spread to his trunk and upper extremities. WHAT IS YOUR DIAGNOSIS? HOW WOULD YOU TREAT THIS PATIENT?

摘要

一名74岁的高加索男性因顽固性背痛、胸痛、弥漫性皮疹和精神状态改变入院。他说，两天前，他因3天前开始的背痛和头痛前往当地另一家医院就诊。他接受了静脉注射氢吗啡酮治疗，并带着哌替啶处方回家。他说，在接受氢吗啡酮治疗数小时后，他的头部出现皮疹，然后蔓延至躯干和上肢。你的诊断是什么？你会如何治疗这名患者？