心脏移植术后发生中毒性表皮坏死松解症可能与头孢哌酮钠舒巴坦钠有关。
Toxic epidermal necrolysis following heart transplantation may caused by cefoperazone sodium and sulbactam sodium.
机构信息
Department of Cardiac Surgery Intensive Care Unit, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China.
Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, 510080, China.
出版信息
J Cardiothorac Surg. 2024 Sep 23;19(1):542. doi: 10.1186/s13019-024-03025-x.
BACKGROUND
The outcome of heart transplantation is significantly affected by perioperative infections. Individualised immunosuppression strategies are essential to reduce the risk of such infections.
CASE PRESENTATION
We report the successful management of a 56-year-old male patient diagnosed with dilated cardiomyopathy who underwent heart transplantation. During the perioperative period, the patient was prescribed cefoperazone sodium and sulbactam sodium, which induced a severe skin reaction: toxic epidermal necrolysis (TEN). The patient was treated with prednisone, immunoglobulins, etanercept, and other active immunomodulatory measures, together with an individualised anti-rejection regimen and physical therapy. The systemic rash resolved within a month, and the patient was successfully discharged after surgery.
CONCLUSION
Effective management of heart transplantation necessitates balancing immunosuppression and infection prevention. Individualised immunosuppressive strategies are critical for optimal clinical outcomes.
背景
心脏移植的结果受围手术期感染的显著影响。个体化的免疫抑制策略对于降低此类感染的风险至关重要。
病例介绍
我们报告了一位成功管理的 56 岁男性扩张型心肌病患者，他接受了心脏移植。在围手术期，该患者被开处头孢哌酮钠和舒巴坦钠，这引发了严重的皮肤反应：中毒性表皮坏死松解症（TEN）。该患者接受了泼尼松、免疫球蛋白、依那西普和其他主动免疫调节措施，以及个体化的抗排斥方案和物理治疗。全身性皮疹在一个月内消退，患者在手术后成功出院。
结论
有效管理心脏移植需要平衡免疫抑制和感染预防。个体化的免疫抑制策略对于获得最佳临床结果至关重要。
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