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结核性颈淋巴结病中药物性嗜酸性粒细胞增多和全身症状(DRESS)综合征表现:一例报告

A Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) Syndrome Manifestation in Tubercular Cervical Lymphadenopathy: A Case Report.

作者信息

Bagrecha Mahavir, Balamoni Vinay, Ganta Siri Vineeth A

机构信息

Respiratory Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Center, Dr. D. Y. Patil Vidyapeeth, Pune, IND.

出版信息

Cureus. 2024 Aug 26;16(8):e67783. doi: 10.7759/cureus.67783. eCollection 2024 Aug.

Abstract

A severe adverse reaction linked to a variety of medications, Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome is typified by a severe mucocutaneous rash, eosinophilia, fever, lymphadenopathy, and widespread systemic involvement. A 30-year-old female patient presented with fever, facial flushing, and a maculopapular rash that had been persistent for seven days on the upper limb, chest, belly, and lower limbs. She also had a cough with breathlessness for seven days which had progressed over the last seven days and also a rise in temperature in the evening. As the patient was started on anti-tubercular treatment (ATT) based on an interferon-gamma release assay report with no constitutional symptoms, we decided to reconfirm the diagnosis. Ultrasonography of the neck showed cervical lymphadenopathy measuring 21x11 mm in the left cervical region at level IB. The patient was advised for cervical lymph node fine needle aspiration to be sent for cytology and cartridge-based nucleic acid amplification test (CBNAAT) to restart ATT. The patient is being followed up.

摘要

药物超敏反应伴嗜酸性粒细胞增多和全身症状(DRESS)综合征是一种与多种药物相关的严重不良反应,其典型表现为严重的黏膜皮肤皮疹、嗜酸性粒细胞增多、发热、淋巴结病以及广泛的全身受累。一名30岁女性患者出现发热、面部潮红,上肢、胸部、腹部和下肢出现持续7天的斑丘疹。她还伴有咳嗽和气促7天,在过去7天里病情进展,且晚间体温升高。由于患者根据干扰素-γ释放试验报告开始接受抗结核治疗(ATT)时无全身症状,我们决定重新确诊。颈部超声显示左侧IB区颈部淋巴结病,左颈区域淋巴结大小为21x11mm。建议患者进行颈部淋巴结细针穿刺,送检细胞学检查和基于试剂盒的核酸扩增试验(CBNAAT)以重启抗结核治疗。该患者正在接受随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d9c3/11422788/82d457687a09/cureus-0016-00000067783-i01.jpg

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