<b>1</b>例疑似接种狂犬疫苗发生脓毒性休克死亡病例的调查

张丽丽; 吴向青; 张昌磊

doi:10.19428/j.cnki.sjpm.2021.20830

1例疑似接种狂犬疫苗发生脓毒性休克死亡病例的调查

Freeze-dried rabies vaccine followed by death due to septic shock： a case report

摘要

摘要:
目的分析1起接种冻干人用狂犬病疫苗后偶合死亡的案例，为今后狂犬病疫苗的接种和预防接种异常反应调查诊断的开展提供参考。
方法收集和分析受种者疫苗接种、临床症状、发病与治疗经过、调查诊断等资料。
结果狂犬病暴露预防处置和接种均符合现行规范。受种者接种狂犬病疫苗第3日出现发热无力、头痛头晕、腹泻等症状，病情迅速进展，白细胞计数、中性粒细胞计数等进行性升高，当日17时左右抢救无效临床死亡，未做尸检。
结论导致患者脓毒症/脓毒性休克的病因不明。有必要制定详尽的狂犬病疫苗免疫程序和预防接种异常反应调查诊断领域相关的规范、专家共识。

Abstract:
ObjectiveTo analyze a case of death after inoculation of a freeze-dried rabies vaccine for human use so as to provide reference for the vaccination of the rabies vaccine and the process of investigation and diagnosis involving adverse events following immunization （AEFI） in the future.
MethodsData on vaccination， clinical symptoms， treatments， investigation and diagnosis were collected and analyzed.
ResultsRabies post-exposure prophylaxis and vaccination were in line with the protocols. On the 3rd day after the inoculation of the rabies vaccine， the patient developed fever， weakness， headache， dizziness， diarrhea and other symptoms. The white blood cell count and neutrophil count increased progressively. At about 17：00 on the same day， the patient suffered a sudden cardiac arrest and died clinically. Autopsy was not carried out.
ConclusionThe cause of sepsis /septic shock of the patient is unknown. It is necessary to formulate detailed rabies immunization procedures as well as norms and expert consensus in the field of investigation and diagnosis of AEFI.

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