Toxic epidermal necrolysis following heart transplantation may caused by cefoperazone sodium and sulbactam sodium.

IF 1.5 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiothoracic Surgery Pub Date : 2024-09-23 DOI:10.1186/s13019-024-03025-x

Zeng Xiaodong, Wu Min, Lei Liming, Huang Jinsong, Qi Xiao, Liang Yuemei, Wu Yijin

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Abstract

Background: The outcome of heart transplantation is significantly affected by perioperative infections. Individualised immunosuppression strategies are essential to reduce the risk of such infections.

Case presentation: We report the successful management of a 56-year-old male patient diagnosed with dilated cardiomyopathy who underwent heart transplantation. During the perioperative period, the patient was prescribed cefoperazone sodium and sulbactam sodium, which induced a severe skin reaction: toxic epidermal necrolysis (TEN). The patient was treated with prednisone, immunoglobulins, etanercept, and other active immunomodulatory measures, together with an individualised anti-rejection regimen and physical therapy. The systemic rash resolved within a month, and the patient was successfully discharged after surgery.

Conclusion: Effective management of heart transplantation necessitates balancing immunosuppression and infection prevention. Individualised immunosuppressive strategies are critical for optimal clinical outcomes.

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头孢哌酮钠和舒巴坦钠可能会引起心脏移植后的中毒性表皮坏死。

背景：心脏移植手术的结果受到围手术期感染的严重影响。个性化的免疫抑制策略对于降低此类感染的风险至关重要：我们报告了一名被诊断为扩张型心肌病的 56 岁男性患者接受心脏移植的成功治疗。在围手术期，患者服用了头孢哌酮钠和舒巴坦钠，结果引发了严重的皮肤反应：中毒性表皮坏死（TEN）。患者接受了泼尼松、免疫球蛋白、依那西普和其他积极的免疫调节措施，以及个性化的抗排斥方案和物理治疗。全身皮疹在一个月内消退，患者术后顺利出院：结论：心脏移植手术的有效管理必须兼顾免疫抑制和感染预防。个性化的免疫抑制策略对于取得最佳临床效果至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cardiothoracic Surgery 医学-心血管系统

CiteScore

2.50

自引率

6.20%

发文量

286

审稿时长

4-8 weeks

期刊介绍： Journal of Cardiothoracic Surgery is an open access journal that encompasses all aspects of research in the field of Cardiology, and Cardiothoracic and Vascular Surgery. The journal publishes original scientific research documenting clinical and experimental advances in cardiac, vascular and thoracic surgery, and related fields. Topics of interest include surgical techniques, survival rates, surgical complications and their outcomes; along with basic sciences, pediatric conditions, transplantations and clinical trials. Journal of Cardiothoracic Surgery is of interest to cardiothoracic and vascular surgeons, cardiothoracic anaesthesiologists, cardiologists, chest physicians, and allied health professionals.