Abstract：
Leukocytoclastic vasculitis (hypersensitivity vasculitis) is defined as small blood vessel inflammation with skin or other systemic manifestations due to infections, drugs, or neoplastic disease. This clinical case report highlights an association between ceftriaxone and leukocytoclastic vasculitis in a 49-year-old female patient with a history of penicillin allergy, on mirtazapine for anxiety disorder. Articles concerning antibiotic-induced leukocytoclastic vasculitis are also reviewed. The patient reported a symptom of upper respiratory tract infection and fever 5 days previously for which she received ceftriaxone for 2 days before presenting to the emergency department with a pruritic skin rash in the upper and lower extremities and swollen lips for 1 day. The rash was erythematous, maculopapular, itchy, and non-tender, with no mucus membrane involvement. Laboratory investigations revealed leukocytosis (white blood cells, 22.3 × 109/L) that was mainly eosinophilic (18.4%). The patient was administered prednisolone and antihistamine after stopping ceftriaxone empirically. A skin biopsy confirmed the diagnosis of leukocytoclastic vasculitis. Significant clinical improvement was observed after treatment initiation. Upon follow-up, the skin rash was resolved entirely with no scars; however, there was skin-peeling over the lower extremities. Recognition of antibiotic-induced leukocytoclastic vasculitis is crucial as many classes of antibiotics can contribute to this condition. Continuation of the offending drug may lead to life-threatening complications.
摘要：
白细胞碎裂性血管炎（超敏反应性血管炎）被定义为由于感染引起的皮肤或其他全身表现的小血管炎症，毒品,或肿瘤性疾病。该临床病例报告强调了头孢曲松与白细胞碎裂性血管炎之间的关联，该患者49岁，有青霉素过敏史。米氮平治疗焦虑症.还综述了有关抗生素诱导的白细胞碎裂性血管炎的文章。患者在5天前报告了上呼吸道感染和发烧的症状，为此她接受了头孢曲松2天，然后到急诊科就诊，上肢和下肢出现瘙痒性皮疹，嘴唇肿胀1天。皮疹是红斑,斑丘疹,发痒,和非招标，没有粘膜受累.实验室检查显示白细胞增多（白细胞，22.3×109/L），主要为嗜酸性粒细胞（18.4%）。经验停止头孢曲松后，患者给予泼尼松龙和抗组胺药。皮肤活检证实了白细胞碎裂性血管炎的诊断。治疗开始后观察到显著的临床改善。在后续行动中，皮疹完全缓解，没有疤痕；然而，下肢有脱皮现象。识别抗生素诱导的白细胞碎裂性血管炎至关重要，因为许多类别的抗生素都可能导致这种情况。继续服用有问题的药物可能会导致危及生命的并发症。
