延迟诊断一个隐形的发作:Cefepime诱导的非状态
Saint-Martin Allihien1, Sammudeen Ibrahim2, Prabina Basnet1
1Internal Medicine, Piedmont Athens Regional Medical Center, Athens, USA.
Cureus
|November 13, 2023
概括
塞费皮姆诱发的非性状态 (NCSE) 是一种严重的不良事件. 这一案例表明,即使采取预防措施,NCSE也可能发生,强调迅速诊断和为患者安全而停止使用cefepime.
科学领域:
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
- 传染性疾病 传染性疾病
背景情况:
- 塞菲皮姆是一种常用的抗生素,具有已知的神经系统不良事件风险.
- 非性状态 (NCSE) 是一种已知的,尽管不常见的,塞费皮姆治疗的不良影响.
- 塞费皮姆诱导的NCSE的危险因素包括晚年,功能障碍和先前存在的大脑疾病.
研究的目的:
- 在老年患者中报告Cefepime诱导的NCSE病例.
- 突出NCSE的诊断挑战和临床影响.
- 强调早期认可和早期撤销的重要性.
主要方法:
- 一个79岁的女性患者的案例研究,因为 Pseudomonas aeruginosa 感染而入院.
- 急性脑病变的临床表现与肌细胞抽.
- 电脑电图 (EEG) 确认NCSE与一般的周期性放电.
- 终止了塞菲皮姆的使用,并用皮佩拉林-塔扎巴克坦替换.
主要成果:
- 患者在开始服用cefepime的11天后出现了急性脑病变和EEG确认的NCSE.
- 在停止服用塞费皮姆后的两天内,NCSE解决了问题.
- 该患者以前没有发作史,并接受了塞费皮姆与脏剂量调整.
结论:
- 尽管遵守推剂量预防措施,但Cefepime诱导的NCSE可能会发生.
- 在高危患者中,高怀疑指数对于及时诊断和管理NCSE至关重要.
- 及时停止使用塞菲皮姆对于完全恢复和预防可能致命的结果至关重要.
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