患有传染性内心炎的患者的万科米辛相关的急性间歇性炎
Justin Riley Lam1, Mikaela Nikkola Jara-Tantoco2, Anshel Bright2
1Internal Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA justin.lam@jefferson.edu.
BMJ case reports
|June 12, 2025
概括
范科米辛可以引起急性间歇性炎 (AIN),这是一种罕见的损伤. 早期监测万科米辛水平至关重要,以防止严重的毒性和潜在的透析.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 范科米辛是治疗格拉姆阳性感染的关键抗生素,包括耐美西林黄金葡萄球菌 (MRSA).
- 范科米辛诱导的毒性是一种已知的并发症,通常呈现为急性管状亡 (ATN),但很少呈现为急性间歇性炎 (AIN).
- 范科米辛脏毒性的危险因素包括高剂量,延长治疗时间,同时使用其他脏毒剂,以及先前存在的功能障碍.
研究的目的:
- 报告一种罕见的急性间歇性炎 (AIN) 病例,该病例是万科米辛治疗的次要病例.
- 突出临床表现,诊断挑战和万科米辛诱导的AIN的管理.
- 强调治疗药物监测万科米辛的重要性,以预防严重的脏并发症.
主要方法:
- 一份病例报告详细介绍了一名患者在感染性内心炎的万科米辛治疗期间发展了AIN.
- 临床数据审查,包括血清肌水平,万科米辛最低水平和脏活检结果.
- 对停止使用万科米辛和使用皮质类固醇治疗的治疗反应的评估.
主要成果:
- 一名70岁的男性患有并发症,在接受了万科米辛治疗9天后出现了AIN.
- 血清肌素从1.2升至5.5毫克/分升,与40毫克/毫升的超治疗性万科米辛水平相吻合.
- 脏活检证实了AIN,尽管放弃了万科米辛,但功能下降,需要血液透析和高剂量的皮质类固醇.
结论:
- 急性间歇性炎 (AIN) 是一种罕见但严重的万科米辛的不良反应.
- 密切监测万科米辛水平和功能至关重要,特别是在有风险因素的患者中.
- 及时识别和管理,包括药物戒断和免疫抑制,对于减轻万科米辛诱导的毒性至关重要.
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