A 53-year-old male patient was treated with ambroxol hydrochloride injection(30 mg:100 mL,st,ivgtt)and levofloxacin sodium chloride injection(0.5 g:100 mL,st,ivgtt)due to upper respiratory tract infection on December 23,2022.After intravenous infusion of levofloxacin sodium chloride injection for about 17 minutes(about 25 mL),the patient developed to chest tightness and palpitations,shortness of breath,skin itching,and then transient loss of consciousness(TLOC)and no response to a verbal command,urinary incontinence,as well as skin reactions such as rash,skin redness,and swelling.The infusion was immediately stopped,the infusion device was replaced,the routine and special care,electrocardiogram monitoring,2 L·min-1 oxygen inhalation,bedridden rest and opening of venous access were carried out by the emergency internal medicine department,the case was given intramuscular injection of 25 mg of promethazine hydrochloride injectionand was transported to the emergency room.During the process,the patient regained consciousness and lasted for 3 minutes.and the condition was remarkably improved after oxygen inhalation,use of antihistamines,corticosteroids,intravenous infusion.The case scored 7 points by the Naranjo's evaluation scale,taking into account the immediate drug hypersensitivity reaction(IDHR)caused by levofloxacin sodium chloride injection,with TLOC as the clinical manifestation.
Immediate drug hypersensitivity reactionLevofloxacinTransient loss of consciousnessUrinary incontinence