磷霉素过敏致弥散性血管内凝血死亡

1例51岁男性患者,因发热、寒战给予复方氨林巴比妥2mL肌内注射。因效果不佳,遂于1h后给予磷霉素4g加入5%葡萄糖注射液250mL中静脉滴注。输注过程中患者出现胸闷,气促,寒战症状加重。遂停止输液,经治疗症状无好转,且出现呼吸困难。次日患者颜面及全身皮肤明显发绀、出现大片花斑,眼睑水肿,结膜充血,四肢湿冷,双肺可闻及湿啰音.实验室检查：PLT45×10^9/L。血浆凝血酶原时间37.3s,活化部分凝血活酶时间78.1s,血浆D-二聚体1600～3200μg/L。最终,患者经抢救无效死亡。

Death from disseminated intravascular coagulation caused by anaphylaxis due to phosphonomycin

A 51-year-old male patient received IM compound aminophenazone and barbital injection 2 mL for fever and chill. One hour later,an IV infusion of phosphonomycin 4 g in 5% glucose 250 mL was given due to poor efficacy. During the infusion,the patient developed chest distress,shortness of breath,and the symptom of chill was aggravated. Subsequently,phosphonomycin was withdrawn and promethazine,adrernalin,dexamethasone,and dextran were given. However,the symptoms did not improve and the patient experienced dyspnea. The next day,he presented with marked cyanosis in the face and whole body skin with massive ecchymosis,palpebral edema,conjunctival congestion,and cool clammy extremities. Moist rales were heard in both lungs. Laboratory examination showed a PLT level of 45×10^9/L,a prothrombin time of 37.3 s,an activated partial thromboplastin time of 78.1 s,and a D-dimer level of 1 600-3 200 μg/L. Finally,he died despite resucitation efforts.