Female patient, 24 years old, who consulted for three days of general malaise, colic pain in the lower hemi-abdomen, dysuria, pollakinesia, nausea, vomiting and chills
He did not report back pain or fever.
He was admitted in regular general condition, as wound dressing.
BP 90/60 mmHg, FC 118' FR22'.
The rest of the physical examination was described within normal limits.
The patient had a previously requested uroculture positive report of > 100,000 Escherichia coli susceptible to multiple antibiotics, including quinolones.
Rehydration was initiated and a metabolic acidosis, leukocytosis and neutrophilia, creatininemia of 1.2 mg/dl and normal electrolytes were diagnosed.
Urine analysis was compatible with urinary infection.
Given these clinical and laboratory findings, she was hospitalized for hydration and intravenous antibiotic therapy, with ciprofloxacin 400 mg IV every 12 hours being indicated.
The patient progressed slowly toward improvement, but 36 hours after starting antimicrobial therapy, he developed a generalized maculo-papular rash, pruriginous, and deterioration of consciousness, associated with a seizure episode.
Ciprofloxacin was discontinued, an antihistamine and IV corticosteroids were administered and a brain CT scan was performed, which was normal.
The patient was successfully treated with ceftriaxone.
She was discharged on the first day after admission.
1.
To obtain a more accurate diagnosis, a prick-test was performed four weeks later, which was positive with a halo of 5 mm greater than the control.
In addition, a challenge test was performed with low dose oral exposure (250 mg) of ciprofloxacin during which you experienced an allergic reaction with pruritus, cough and dyspnoea.
