Al-Ansari Rehab Y, Almuhaish Leena Abdulrahman, Hassan Khaled Abdullah, Fadoul Tawasoul, Woodman Alexander
Adult Hematology Unit, Internal Medicine Department, King Fahd Military Medical Complex, Dhahran, Saudi Arabia.
Dermatology Unit, Internal Medicine Department, King Fahd Military Medical Complex, Dhahran, Saudi Arabia.
Case Rep Dermatol Med. 2024 Mar 15;2024:9975455. doi: 10.1155/2024/9975455. eCollection 2024.
A fixed drug eruption (FDE) is an immunological cutaneous adverse reaction, classified as a cutaneous adverse drug reaction (CADR) and characterized by well-defined lichenoid lesions that occur at the same site each time. Ceftriaxone is a third-generation antibiotic of cephalosporin antibiotics of the beta-lactam antibiotic family, which has typical activity against many Gram-negative aerobic bacteria. This is the first clinical case from Saudi Arabia and the fifth in the world to document a woman's experience with recurrent FDE after repeated ceftriaxone use. . A 25-year-old Saudi woman with a known case of sickle cell anemia (SCA) with a history of avascular necrosis of the right hip after replacement was hospitalized with a pain crisis triggered by an upper respiratory tract infection. The patient denied having a history of allergy previously. Due to fever, leukocytosis, and active follicular tonsillitis, ceftriaxone was started. However, a few hours later she developed lip edema and a fixed drug eruption measuring 7 × 11 cm on the left side of her back. The lesion reformed over a hyperpigmented lesion (4 × 8 cm) that the patient did not report upon initial examination. It turned out that this was due to the intravenous administration of ceftriaxone, a year ago in another hospital. An allergy to ceftriaxone was considered, and steroids and antihistamines were started. The case was labeled as ceftriaxone induced FDE.
Ceftriaxone induced FDE is an uncommon type of allergic reaction that has been reported infrequently. Understanding this condition and the mechanism by which FDE becomes recurrent with the same previous fixed lesion is of great importance for both academic and future research purposes.
固定性药疹（FDE）是一种免疫性皮肤不良反应，归类为皮肤药物不良反应（CADR），其特征是每次都在同一部位出现边界清晰的苔藓样病变。头孢曲松是β-内酰胺类抗生素家族中头孢菌素类抗生素的第三代，对许多革兰氏阴性需氧菌具有典型活性。这是沙特阿拉伯的首例临床病例，也是世界上第五例记录一名女性在反复使用头孢曲松后出现复发性FDE的病例。一名25岁的沙特女性，已知患有镰状细胞贫血（SCA），右髋关节置换后有缺血性坏死病史，因上呼吸道感染引发疼痛危象而住院。患者否认既往有过敏史。由于发热、白细胞增多和活动性滤泡性扁桃体炎，开始使用头孢曲松。然而，几个小时后，她出现唇部水肿，并在背部左侧出现一处7×11厘米的固定性药疹。该皮疹在患者初次检查时未报告的一处色素沉着病变（4×8厘米）上重新出现。结果发现，这是一年前在另一家医院静脉注射头孢曲松所致。考虑对头孢曲松过敏，开始使用类固醇和抗组胺药。该病例被诊断为头孢曲松诱导的FDE。
头孢曲松诱导的FDE是一种罕见的过敏反应类型，报道较少。了解这种情况以及FDE如何在同一既往固定病变处复发的机制，对于学术研究和未来研究都非常重要。
