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头孢曲松诱导的II型库尼斯综合征的急诊处理:一例报告

Emergency management of ceftriaxone-induced Type II Kounis syndrome: A case report.

作者信息

Wang Jiali, Jiang Zhenhua

机构信息

Shaoxing Central Hospital, Shaoxing, Zhejiang Province, China.

出版信息

Medicine (Baltimore). 2025 Jun 20;104(25):e42917. doi: 10.1097/MD.0000000000042917.

Abstract

RATIONALE

Ceftriaxone, a broad-spectrum β-lactam antibiotic, can induce severe allergic reactions such as anaphylaxis, which may lead to life-threatening type II Kounis syndrome (K-S), a variant of acute coronary syndrome triggered by allergic reactions. This case report aims to enhance the clinical understanding of ceftriaxone-induced type II K-S by presenting a detailed account of a patient's emergency management and subsequent recovery, emphasizing the importance of early recognition, intervention, and the role of nursing care in achieving a favorable outcome.

PATIENT CONCERNS

A 73-year-old male with no known allergy history was admitted for cough and shortness of breath. After ceftriaxone administration, he developed chest tightness, shortness of breath, hypotension, and abdominal rash.

DIAGNOSES

Type II K-S triggered by ceftriaxone-induced anaphylaxis was diagnosed.

INTERVENTIONS

Immediate management included discontinuing ceftriaxone, emergency tracheal intubation, and intravenous epinephrine. Emergency coronary angiography showed no significant coronary artery stenosis. Postoperatively, the patient received antiplatelet therapy, plaque stabilization, and vasodilation in the intensive care unit.

OUTCOMES

The patient's condition stabilized, tracheal intubation was removed, and he was discharged after 10 days of treatment with significant clinical improvement.

LESSONS

This case emphasizes the critical importance of early recognition and management of ceftriaxone-induced type II K-S. Vigilant monitoring for allergic reactions and a multidisciplinary approach to care are essential for achieving favorable patient outcomes.

摘要

理论依据

头孢曲松是一种广谱β-内酰胺抗生素,可诱发严重过敏反应,如过敏症,这可能导致危及生命的II型库尼斯综合征(K-S),这是一种由过敏反应引发的急性冠状动脉综合征变体。本病例报告旨在通过详细描述一名患者的急诊处理及随后的康复情况,增强对头孢曲松诱发的II型K-S的临床认识,强调早期识别、干预的重要性以及护理在取得良好预后中的作用。

患者情况

一名73岁男性,无已知过敏史,因咳嗽和气短入院。使用头孢曲松后,他出现胸闷、气短、低血压和腹部皮疹。

诊断

诊断为头孢曲松诱发过敏反应引发的II型K-S。

干预措施

立即处理包括停用头孢曲松、紧急气管插管和静脉注射肾上腺素。急诊冠状动脉造影显示无明显冠状动脉狭窄。术后,患者在重症监护病房接受抗血小板治疗、斑块稳定和血管舒张治疗。

结果

患者病情稳定,气管插管拔除,治疗10天后出院,临床症状有显著改善。

经验教训

本病例强调了早期识别和处理头孢曲松诱发的II型K-S的至关重要性。对过敏反应进行警惕监测以及采用多学科护理方法对于取得良好的患者预后至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d22d/12187265/e7514396e3a8/medi-104-e42917-g001.jpg

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