Ziaya P R, Hankins G D, Gilstrap L C, Halsey A B
JAMA. 1986 Nov 14;256(18):2561-2.
Untreated syphilis during pregnancy may result in stillbirth in one fourth of cases, while in infants who survive, there may be serious immediate and delayed manifestations. Penicillin is the drug of choice for treating both mother and fetus. We describe a woman with an allergy against both major and minor determinants of penicillin in whom syphilis was diagnosed on routine obstetric screening. Her obstetric history included one vaginal delivery at term and four subsequent spontaneous abortions at 12 to 16 weeks. The patient underwent desensitization utilizing graduated intravenous doses of penicillin followed by treatment with a constant infusion for eight days. She experienced no serious allergic reactions requiring alteration of therapy. We conclude that antibiotic desensitization may be a safe alternative during pregnancy if performed with careful monitoring. In this case, it allowed use of penicillin rather than less desirable alternatives.
孕期未经治疗的梅毒在四分之一的病例中可能导致死产，而对于存活下来的婴儿，可能会有严重的即刻和延迟表现。青霉素是治疗母亲和胎儿的首选药物。我们描述了一名对青霉素的主要和次要决定簇均过敏的女性，她在常规产科筛查中被诊断出患有梅毒。她的产科病史包括一次足月阴道分娩以及随后在12至16周时的四次自然流产。该患者通过静脉逐渐增加剂量的青霉素进行脱敏，随后持续输注青霉素治疗八天。她没有出现需要改变治疗方案的严重过敏反应。我们得出结论，如果在仔细监测下进行，抗生素脱敏在孕期可能是一种安全的替代方法。在这个病例中，它使得能够使用青霉素而非不太理想的替代药物。
