滥用误用
Wu Yurong
2007, 9(5): 339-340.
A 15-year-old girl received IV dexamethasone(dosage not stated)for a fever(T 38.4 ℃)2 days after the occurrence of eruption.The next day,her skin rash aggravated and she developed hemorrhagic herpes accompanied by lumbago.The third day,she developed headache,nausea,and vomiting.Laboratory tests revealed the results as follows:WBC 19.65×109/L,RBC 3.65×1012/L,Hb 123 g/L,PLT 46×109/L,ALT 4 247 U/L,AST 4 719 U/L,LDH 1 209 U/L,and CK 612 U/L.After hospitalization,the patient presented with trance,tenderness over the abdomen,percussion pain in the both renal region.Her heart rate was 130 beats/min and blood pressure was 86/60 mmHg.Laboratory tests showed the following values:WBC 17.4×109/L,L 0.32,RBC 2.56×1012/L,Hb 93 g/L,PLT 27×109/L,urine occult blood(+),PO2 11.76 mmHg,and PCO2 2.5 mmHg.She had a history of contacting closely with the patient with varicella within 2 weeks.She was diagnosed as varicella,varicella encephalitis,multiorgan injury,infective shock,disseminated intravascular coagulation,and metabolic acidosis.The patient was given treatments with elevation of blood pressure,blood volume expansion,hemostasis,correction of acidosis,anti-infection.But she developed haematemesis,continuous bleeding from oral and nasal cavity,anuria,blood pressure reduction,and deep coma.She died 12 hours after hospitalization.
