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患者女,25岁,因突发意识障碍10min于2002年1月26日入院。入院前患者因发热、咽痛2d诊断为化脓性扁桃体炎,于单位卫生所给予红霉素0.5g+5％葡萄糖注射液500ml中静滴,10min后患者出现皮肤瘙痒,继之周身皮疹,大汗,患者诉气促、胸闷、头晕、恶心,随继出现昏迷,立即停止注射,急送入我院。患者有青霉素过敏史。查体:T 39.7℃,BP 50/30mmHg,浅昏迷状,呼吸急促,皮肤潮湿,可见散在荨麻疹,浅表淋巴结不大,咽部充血,扁桃体Ⅱ°肿大,有脓点,双肺闻及哮鸣音,HR 132次·min~(-1),律整,无杂音。心电图示窦性心动过速,ST-T无改变。立即给予吸氧,静脉注射地塞米松10mg,多巴胺40mg,间羟胺50mg,肾上腺素0.5mg及5％葡萄糖注射液250ml+维生素C2g、维生素B_60.1g静滴,qd,约15min后患者神志转清,气促缓解,血压上升至100/60mmHg,改用环丙沙星100ml静滴,bid
Female, 25 years old, admitted to hospital on January 26, 2002 due to sudden disturbance of consciousness 10 min. Patients admitted to hospital due to fever, sore throat 2d diagnosis of suppurative tonsillitis, erythromycin 0.5g + 5% in units of health clinics to give intravenous infusion of 500ml of glucose injection, 10min patients with skin pruritus, followed by percutaneous rash, large Khan, patients with shortness of breath, chest tightness, dizziness, nausea, followed by a coma, immediately stop injection, urgently into our hospital. Patients have a history of penicillin allergy. Examination: T 39.7 ℃, BP 50 / 30mmHg, shallow coma, shortness of breath, wet skin, visible scattered urticaria, superficial lymph nodes, pharyngeal hyperemia, tonsil enlargement, pus point, lung smell And wheeze, HR 132 times min ~ (-1), the whole law, no noise. ECG showed sinus tachycardia, ST-T no change. Immediately given oxygen, intravenous injection of dexamethasone 10mg, dopamine 40mg, hydroxylamine 50mg, epinephrine 0.5mg and 5% glucose injection 250ml + vitamin C2g, vitamin B_60.1g intravenous infusion, qd, about 15min patients consciousness clear, Shortness of breath to ease, blood pressure rose to 100 / 60mmHg, switched to ciprofloxacin 100ml intravenous infusion, bid