Kadoya A, Iikuni Y, Hosaka S, Okada J, Kondo H
Department of Internal Medicine, Kitasato University, School of Medicine.
Kansenshogaku Zasshi. 1996 Dec;70(12):1279-83. doi: 10.11150/kansenshogakuzasshi1970.70.1279.
We experienced a SLE patient with TSS after delivery. A 32-year-old SLE patient was transferred to our division due to fever, diarrhea, erosive rash, pericardial effusion, myalgia, low blood pressure, thrombocytopenia and hypoproteinemia which appeared two days after transvaginal delivery. At the time of admission, we considered these symptoms as the exacerbation of SLE, and treatment with high doses of steroid was started. It was when TSST-1-producing-MRSA was cultured from the vagina and uterus that TSS was suspected. 2 g/day of vancomycin was administered and her symptoms improved. As observed in this case, it is important to consider TSS as one of the complications seen with SLE patients after delivery.
我们遇到了一位产后发生中毒性休克综合征(TSS)的系统性红斑狼疮(SLE)患者。一名32岁的SLE患者因经阴道分娩两天后出现发热、腹泻、糜烂性皮疹、心包积液、肌痛、低血压、血小板减少和低蛋白血症而转入我科。入院时,我们认为这些症状是SLE的加重,并开始使用大剂量类固醇进行治疗。当从阴道和子宫培养出产生毒性休克综合征毒素-1(TSST-1)的耐甲氧西林金黄色葡萄球菌(MRSA)时,怀疑发生了TSS。给予万古霉素2克/天,她的症状有所改善。正如本病例所观察到的,将TSS视为SLE患者产后出现的并发症之一很重要。