1例疑似头孢菌素类与碳青霉烯类交叉过敏致DRESS病例报道

打开文本图片集

中图分类号R979.9 文献标志码A 文章编号 1001-0408（2025）15-1915-06

DOI10.6039/j.issn.1001-0408.2025.15.17

DRESS caused by suspected cross-allergy between cephalosporins and carbapenems： a case report HELu，QIAN Yan（ Afliated ， ，）

ABSTRACTOBJECTIVETo explore the pathogenesis，diagnosis andtreatment drug reaction with eosinophiliaand systemic symptoms（DRESS）causedbycrossallergybetweencephalosporinsandcarbapenems，andprovidereference forsafeclinical medication.METHODS Clinicalpharmacistsparticipated inthediagnosisandtreatmentprocessapatientwithseverepeumonia whose DRESScausedbysuspected cro-alergy betweencephalosporinsandcarbapenems inourhospital.Atthesame time， relevantstudiesonthepathogenesis，diagnosis，treatment，andcros-alergybetweencephalosporinsandcarbapenemswere retrievedforanalysis.Basedonthclinicalmanifestationsandtreatmentprocessthispatient，theposiblemechansmscrossallrgy betwencephalosporinsandcarbapenemsand thetreatmentstrategiesforDRESSwere discussed.RESULTSThe RegiSCAR score this patient was 6 points，confirming the diagnosis DRESS. There may be β -lactam ring-specific human leucocyteantigenallelesorT-cellreceptors，whichledtosuspectedcros-alergicreactionsbetweencephalosporinsand carbapenems.Theclinicalpharmacistssuggesteddiscontinuingcephalosporinsandcarbapenemsandusingmethylprednisolone combinedwithimmunoglobulinfortreatment.Thephysicianadoptedthepharmacist’ssuggestion，andthepatientdidnothave feveragainandtherash graduallysubsided.CONCLUsIONs Thereisa posibilitycross-allrgy betweencephalosporinsand carbapenemscausing DRESS.Forpatientswith DRES，itisrecommended topromptlyinvestigatethesuspecteddrugsand discontinuethem.Thecombinationglucocorticoidsandimmunoglobulinisafeasibletreatmentoption.istutionswith conditions should conduct herpesvirus screening and treatment.

KEYWORDSdrug reactions with eosinophilia and systemic symptoms；drug hypersensitivity syndrome； eosinophilia; β -lactams; allergicreaction

伴嗜酸性粒细胞增多和系统症状的药物反应（drugreaction with eosinophilia and systemicsymptoms，DRESS），又称药物超敏反应综合征（drug-inducedhyper-sensitivitysyndrome，DIHS），是一种少见而严重的药物不良反应，以发热、皮疹、嗜酸性粒细胞增多以及潜在的脏器功能损害为主要表现。（剩余14126字）