Exfoliative dermatitis caused by sodium cefodizime

A 66-year-old male patient with obstructive jaundice by percutaneous transhepatic cholangial drainage operation, pulmonary infection was found 15 days later, An IV infusion of cefodizime 2 g once every 12 hours was given for about 12 d and then was shifted to oral cefaclor suspension liquid 0.25 g once every 8 hours. Two days after drug administration, he developed red papules on chest, back and both lower limbs, without itching, adverse reactions induced by cefaclor were considered. The red papules subsided after cefaclor was stopped and intramuscular injection of promethazine hydrochloride 12.5 mg was given. Eight days after stopping cefaclor, the patient underwent an operation which was explorative laparotomy and hepatic hilar biopsy for a space-occupying lesion under general anesthesia. An IV infusion of cefodizime 2 g once every 12 hours was given again for antiinfection, and comprehensive support treatment for prevention of stress ulcer, analgesia, liver protection drugs were given. Three days later, the patient developed skin itching, herpes on lips, facial and torso redness, slight swelling, high skin temperature, a little damder, and erosion on mouth, genital and other parts of the body could be seen with exudation. Exfoliative dermatitis induced by cefodizime was considered. Then all drugs were immediately stopped, IV infusion of methylprednisolone 40 mg, once daily, compound glycyrrhizin injection 60 ml, once daily; oral loratadine 10 mg, once daily; topical use calamine lotion; sodium bicarbonate mouthwash. Two days after administration of the drugs, the patient began to have desquamation, 7 days later the symptoms of exfoliative dermatitis had mitigated, the symptoms of infection gradually improved without using any other anti-infective drugs. Sixteen days later, the symptoms got improved and no symptoms recurred. Key words: Cephalosporins; Drug hypersensitivity; Dermatitis, exfoliative