CAJ | 학술논문

1例43岁男性2型糖尿病患者因糖尿病足坏疽静脉滴注哌拉西林他唑巴坦（4.5 g 入0.9%氯化钠注射液100 ml、1次/8 h）。用药前患者右足肿痛、右足背破溃并有脓性分泌物渗出，体温36.8℃，外周血白细胞计数（WBC）11.5×109/ L，中性粒细胞0.73，嗜酸粒细胞0.02，C 反应蛋白（CRP）104.0 mg/ L。用药第4天足部症状减轻、脓性分泌物减少，WBC 9.4×109/ L，中性粒细胞0.61，嗜酸粒细胞0.03。用药第12天 WBC 6.1×109/ L，中性粒细胞0.60，嗜酸粒细胞0.04。用药第14天患者突然出现高热（41.2℃），WBC 3.4×109/ L，中性粒细胞0.58，嗜酸粒细胞0.11，CRP 11.3 mg/ L，红细胞沉降率86 mm/1 h，降钙素原0.08μg/ L。考虑为哌拉西林他唑巴坦引起的药物热，第15天停用该药。停药48 h 后患者体温下降至36.8℃。停药后1周复查血常规，WBC 9.8×109/ L，中性粒细胞0.70，嗜酸粒细胞0.04。
1례43세남성2형당뇨병환자인당뇨병족배저정맥적주고랍서림타서파탄（4.5 g 입0.9%록화납주사액100 ml、1차/8 h）。용약전환자우족종통、우족배파궤병유농성분비물삼출，체온36.8℃，외주혈백세포계수（WBC）11.5×109/ L，중성립세포0.73，기산립세포0.02，C 반응단백（CRP）104.0 mg/ L。용약제4천족부증상감경、농성분비물감소，WBC 9.4×109/ L，중성립세포0.61，기산립세포0.03。용약제12천 WBC 6.1×109/ L，중성립세포0.60，기산립세포0.04。용약제14천환자돌연출현고열（41.2℃），WBC 3.4×109/ L，중성립세포0.58，기산립세포0.11，CRP 11.3 mg/ L，홍세포침강솔86 mm/1 h，강개소원0.08μg/ L。고필위고랍서림타서파탄인기적약물열，제15천정용해약。정약48 h 후환자체온하강지36.8℃。정약후1주복사혈상규，WBC 9.8×109/ L，중성립세포0.70，기산립세포0.04。
A 43-year-old man with type 2 diabetes was treated with an intravenous(IV)infusion of piperacillin-tazobactam(4. 5 g dissolved in 0. 9% sodium chloride for injection 100 ml,every 8 hours)for diabetic foot gangrene. There were pain,ulceration and purulent secretions on his right foot back before treatment. His body temperature was 36. 8 ℃ . Laboratory test before the treatment showed the following values:white blood cell count(WBC)11. 5 × 109 / L,neutrophil 0. 73,eosinophils 0. 02,C-reactive protein (CRP)104. 0 mg/ L. On day 4 of treatment,the symptom of his foot was alleviated,the purulent secretion from foot was reduced. Laboratory test showed that WBC was 9. 4 × 109 / L,neutrophil 0. 61,eosinophils 0. 03. On day 12 of treatment,laboratory test showed that WBC was 6. 1 × 109 / L,neutrophil 0. 60, eosinophils 0. 04. On day 14 of treatment,the patient had high fever(41. 2 ℃ ),laboratory test showed the following values:WBC 3. 4 × 109 / L,neutrophil 0. 58,eosinophils 0. 11,CRP 11. 3 mg/ L,erythrocyte sedimentation rate 86 mm/ 1 h,procalcitonin 0. 08 μg/ L. The patient was diagnosed as late-onset drug fever due to piperacillin-tazobactam. On day 15,piperacillin-tazobactam was stopped. Forty-eight hours after drug withdrawal,his body temperature decreased to 36. 8 ℃ . The results of reexamination of routine blood test showed almost normalized values:WBC 9. 8 × 109 / L,neutrophil 0. 70,eosinophils 0. 04.