摘要
1例15岁女性患者,因皮肌炎口服泼尼松治疗2年(初始剂量60 mg/d;维持量15 mg/d,隔日1次),出现发热、头痛、呕吐、双下肢无力。经头孢哌酮钠舒巴坦钠、利巴韦林、维生素C及维生素B6治疗无好转,症状进行性加重,出现行走困难。体格检查:体温38.0℃,颈强直;双下肢布满褐色斑疹,部分中央可见脓点;四肢肌力Ⅲ级,肌张力减弱,腱反射减低;Kernig征及Brudzinski征阳性。脑脊液常规检查见大量真菌,白细胞数1×106/L,蛋白890 mg/L,葡萄糖1.4 mmol/L,氯化物99.7 mmol/L,墨汁染色检出新型隐球菌。诊断为新型隐球菌性脑膜炎,虽予积极救治,终因呼吸循环衰竭死亡。
A 15-year-old female patient, who was given oral prednisone with an initial dose of 60 mg/d and a maintained dose of 15 mg/d once every other day for two years because of dermatomyositis, developed fever, headache, vomiting, and weakness of lower limbs. The patient did not have any improvement despite receiving eefoperazone sodium and sulbactam sodium, ribavirin, vitamin C, and vitamin B6. Her symptoms worsened progressively and she became difficult to walk. Physical examination showed a temperature of 38.0 % , nuchal rigidity, brown maculae covering bilateral lower limbs with purulent spot in its center, grade Ⅲ muscle strength, hypomyotonia, diminished tendon reflexes, and positive Kernig＇ s sign and Brudzinski＇ s sign. Routine cerebrospinal fluid test revealed a large number of fungi, a WBC count of 1 × 10^6/L, a protein content of 890 rag/L, a glucose level of 1.4 mmol/L, and a chloride level of 99.7 mmol/L. The indian-ink staining of cerebrospinal fluid showed Cryptococcus neoformans and Cryptococcus neoformans meningitis was diagnosed. The patient died from respiratory and circulatory failure despite active resuscitation.
出处
《药物不良反应杂志》
2012年第1期40-41,共2页
Adverse Drug Reactions Journal
关键词
泼尼松
脑膜炎
隐球菌性
prednisone
meningitis
Cryptococcal
