Wee Hong Chin, Ng Ru Shing, Ong Loke Meng
Clinical Research Centre, Hospital Pulau Pinang, Georgetown, Malaysia; Ministry of Health, Putrajaya, Malaysia.
Institute of Clinical Research, National Institute of Health, Shah Alam, Malaysia.
Eur J Case Rep Intern Med. 2024 Dec 9;11(12):005033. doi: 10.12890/2024_005033. eCollection 2024.
The prevalence of multidrug-resistant and extensively drug-resistant pathogens has led to increased reliance on broad-spectrum antimicrobials, such as tigecycline. This medicine is commonly used to treat complicated skin and intraabdominal infections as well as community-acquired pneumonia. However, the increasing use of tigecycline has been linked to serious complications, including acute pancreatitis.
We present a case of tigecycline-induced acute pancreatitis in a 78-year-old man with complex medical conditions, including type 2 diabetes mellitus, chronic renal insufficiency, and triple vessel disease. The patient was initially treated with tigecycline for bilateral dry gangrene of his toes. Six days after initiation of the tigecycline treatment, the patient developed symptoms of acute pancreatitis with electrocardiogram changes. Magnetic resonance imaging confirmed the diagnosis of acute pancreatitis. Tigecycline was stopped promptly, and supportive treatment was initiated. The patient recovered from the acute pancreatitis and was discharged home. He later passed away at home due to his underlying cardiac disease.
This case highlights the potential complications of tigecycline therapy, particularly in patients with significant comorbidities.
Elderly patients with complex medical issues, such as diabetes mellitus type 2, chronic renal insufficiency, and cardiovascular disease, are at higher risk for adverse drug reactions. Recognizing these risk factors is important for management.Addressing the use of magnetic resonance imaging for diagnosing acute pancreatitis in this specific patient due to their already compromised kidneys highlights the need for a tailored approach. Most commonly, angiographic transformers or computed tomography scan are used for high-risk patients.The symptoms of acute pancreatitis and the presence of cardiac diseases cause problems in managing patients. Changes on the electrocardiogram may suggest cardiac overload; as a result, constant follow-up is necessary for patients suffering from underlying cardiac conditions.
多重耐药和广泛耐药病原体的流行导致对广谱抗菌药物（如替加环素）的依赖增加。这种药物常用于治疗复杂的皮肤和腹腔内感染以及社区获得性肺炎。然而，替加环素使用的增加与严重并发症有关，包括急性胰腺炎。
我们报告一例78岁男性因使用替加环素导致急性胰腺炎的病例，该患者患有多种复杂疾病，包括2型糖尿病、慢性肾功能不全和三支血管病变。患者最初因双足趾干性坏疽接受替加环素治疗。替加环素治疗开始六天后，患者出现急性胰腺炎症状并伴有心电图改变。磁共振成像确诊为急性胰腺炎。立即停用替加环素并开始支持治疗。患者从急性胰腺炎中康复并出院回家。他后来因基础心脏病在家中去世。
该病例突出了替加环素治疗的潜在并发症，尤其是在患有严重合并症的患者中。
患有复杂疾病（如2型糖尿病、慢性肾功能不全和心血管疾病）的老年患者发生药物不良反应的风险更高。识别这些风险因素对治疗管理很重要。由于该特定患者肾脏已经受损，因此针对其使用磁共振成像诊断急性胰腺炎凸显了采取个性化方法的必要性。最常见的是，血管造影变压器或计算机断层扫描用于高危患者。急性胰腺炎的症状和心脏病的存在给患者管理带来问题。心电图改变可能提示心脏负荷过重；因此，对于患有基础心脏病的患者需要持续随访。
