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阿奇霉素引起的紫癜型药疹:1例报告及文献复习

Purpuric Type Drug Eruption Caused by Azithromycin: A Case Report and Literature Review.

作者信息

Saito-Sasaki Natsuko, Sawada Yu

机构信息

Dermatology, University of Occupational and Environmental Health, Kitakyushu, JPN.

出版信息

Cureus. 2024 Feb 14;16(2):e54214. doi: 10.7759/cureus.54214. eCollection 2024 Feb.

Abstract

Azithromycin, an azolide antibiotic with structural and functional similarities to macrolides, possesses distinct features such as its effects persisting for seven days, an extended half-life by administering it once daily for three days, and strong antimicrobial activity. Notably, vomiting and diarrhea are recognized as the primary adverse events related to azithromycin. In this particular case, we present a unique case describing a purpuric-type drug eruption associated with azithromycin, which represents an uncommon cutaneous manifestation. A 64-year-old female developed a purpuric eruption on her trunk and lower extremities seven days after receiving daily intravenous azithromycin for upper bronchitis. A previous occurrence of punctate purpuric eruption following azithromycin administration was documented in her medical history. The diagnosis of azithromycin-induced skin eruption was confirmed based on the clinical progression and the recurrence of the eruption upon re-administration of the drug. In response to this diagnosis, the patient underwent treatment involving the discontinuation of azithromycin and the application of topical betamethasone butyrate propionate ointment. Remarkably, her eruption significantly improved within two weeks, although residual pigmentation persisted post-treatment. Additionally, we offer a comprehensive review of the literature, examining cases of drug eruptions related to azithromycin.

摘要

阿奇霉素是一种氮杂内酯类抗生素,在结构和功能上与大环内酯类相似,具有一些独特的特性,如药效可持续七天,通过连续三天每日给药一次可延长半衰期,以及具有强大的抗菌活性。值得注意的是,呕吐和腹泻被认为是与阿奇霉素相关的主要不良事件。在本病例中,我们呈现了一个独特的案例,描述了与阿奇霉素相关的紫癜型药疹,这是一种罕见的皮肤表现。一名64岁女性在接受每日静脉注射阿奇霉素治疗上支气管炎七天后,躯干和下肢出现紫癜样皮疹。她的病史记录显示之前曾在服用阿奇霉素后出现点状紫癜样皮疹。根据临床进展以及再次给药后皮疹复发的情况,确诊为阿奇霉素诱发的皮肤疹。针对这一诊断,患者接受了停用阿奇霉素并外用丙酸倍他米松丁酸酯软膏的治疗。值得注意的是,尽管治疗后仍有色素沉着残留,但她的皮疹在两周内明显改善。此外,我们对文献进行了全面综述,研究了与阿奇霉素相关的药疹病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4426/10943252/971992a866e9/cureus-0016-00000054214-i01.jpg

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