PDF(Pubmed)
Abstract：
We describe a rare case of a 54-year-old female with hairy cell leukemia, who following treatment for neutropenic sepsis, developed an extensive severe maculopapular exanthema with perifollicular hemorrhage. Cladribine, cotrimoxazole, allopurinol, domperidone, amikacin, piperacillin/tazobactam, and meropenem had all been given in the 9 days prior to eruption onset. Three months later, drug patch testing/delayed intradermal testing was positive to cotrimoxazole, trimethoprim, amikacin, piperacillin/tazobactam, and meropenem, with additional evidence of penicillin cross-reactivity. Drug challenge tests were negative to allopurinol and domperidone. She was diagnosed with multiple drug hypersensitivity to cotrimoxazole, amikacin, piperacillin/tazobactam, and meropenem. Multiple drug hypersensitivity is a novel syndrome mainly seen with severe delayed type IV drug eruptions, involving long-lasting strong T-cell reactivity to two or more structurally unrelated drugs.
摘要：
我们描述了一个罕见的54岁女性毛细胞白血病病例，在中性粒细胞减少性败血症治疗后，发展为广泛的严重斑丘疹性出疹伴卵泡周围出血。克拉屈滨,复方新诺明,别嘌呤醇,多潘立酮,阿米卡星，哌拉西林/他唑巴坦,和美罗培南都是在喷发开始前的9天内服用的。三个月后,药物贴片测试/延迟皮内测试对复方新诺明呈阳性，甲氧苄啶,阿米卡星，哌拉西林/他唑巴坦,还有美罗培南,与青霉素交叉反应的额外证据。药物激发试验对别嘌醇和多潘立酮呈阴性。她被诊断出对复方新诺明有多种药物过敏,阿米卡星，哌拉西林/他唑巴坦,还有美罗培南.多药超敏反应是一种新型综合征，主要表现为严重的迟发型IV型药疹，涉及对两种或多种结构无关的药物的持久强T细胞反应性。
