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作者遇到1例使用先锋霉素Ⅰ引起全血细胞减少的病者,报告如下。患者男性,40岁,患先天性心室间隔缺损。1969年第1次发生细菌性心内膜炎,血培养有草绿色链球菌生长。因对青霉素、氯霉素、链霉素及四环素过敏,故使用头孢菌素Ⅵ治疗。1979年8月1日在没有使用抗菌素预防下拔牙。3天后发热,体温38℃,8月8日入院。体检病人发热、脾肿大、心脏有5～6级收缩期杂音。血培养有草绿色链球菌。实验室检查红细胞压积43%,白细胞9,100,多形核白细胞79%,单核12%,淋巴9%,血小板25万。血尿素氮20mg/dl,血清肌酐1.14mg/dl。给予先锋霉素Ⅰ治疗,8g/天。持续治疗19天后,检查红细胞压积下降至35%,白细胞2,600,嗜中性粒细胞182,血小板10万,Coomb’s 试验阴性。在胸骨、髂骨等3个不同位置取骨髓检查里再生不良。停用先锋霉素Ⅰ,给予碳酸锂
The authors encountered 1 case of neutropenia caused by cephalosporin I. The report is as follows. Male patient, 40 years old with congenital ventricular septal defect. Bacterial endocarditis occurred for the first time in 1969, and Streptococcus viridans grew in blood. Because of penicillin, chloramphenicol, streptomycin and tetracycline allergy, so the use of cephalosporin Ⅵ treatment. August 1, 1979 Tooth extraction without antibiotic prophylaxis. 3 days after fever, body temperature 38 ℃, August 8 admission. Physical examination of patients with fever, splenomegaly, the heart has 5 to 6 systolic murmur. Blood culture with Streptococcus viridans. Laboratory tests hematocrit 43%, white blood cells 9,100, polymorphonuclear leukocytes 79%, mononuclear 12%, lymph 9%, platelets 250,000. Blood urea nitrogen 20mg / dl, serum creatinine 1.14mg / dl. To give cephalosporin Ⅰ treatment, 8g / day. After 19 days of continuous treatment, hematocrit decreased to 35%, leukocyte 2,600, neutrophil 182, platelet 100,000, and Coomb’s test negative. In the sternum, ilium and other 3 different locations to take a bone marrow test in poor regeneration. Pioneer celecoxib Ⅰ disabled, given lithium carbonate