Cefpirome 為第四代頭孢菌素類抗生素， 臨床上用於對革蘭氏陰性菌如Enterobacteriaceae、Pseudomonas aeruginosa 及革蘭氏陽性菌具感受性的感染症。常見副作用包括過敏反應、噁心、嘔吐、腹瀉等，文獻中鮮少提及以視力喪失表現之過敏反應，目前亦尚未有使用cefpirome 引發暫時性黑矇（amaurosis fugax）的文獻報告。本文報告一位B 型肝炎病毒帶原、有痛風性關節炎病史的44 歲男性病患，因膝關節傷口感染接受靜脈滴注cefpirome，三十分鐘後主訴看不見，視力喪失持續約一小時，停用cefpirome 並給予靜脈注射diphenhydramine 及hydrocortisone 後症狀獲得緩解且視力回復。在此藉由文獻回顧，探討cefpirome 引發暫時性黑矇可能的原因及臨床處置建議。
 

Cefpirome is a fourth-generation cephalosporin, which exerts a broad range of bactericidal activity against both Gram-positive and Gram-negative bacterial pathogens, including Enterobacteriaceae and Pseudomonas aeruginosa. The most common adverse effects are hypersensitivity reactions, nausea,vomiting and diarrhea. However, the symptom presented as transient visual loss was less mentioned in the literature. The incidence of cefpirome-induced hypersensitivity reactions with amaurosis fugax has not been reported in the literature so far. We report a case of 44-year-old man, who is a HBV carrier and was diagnosed gouty arthritis before. He was treated with cefpirome for wound infection of knee joint, and complained visual loss following thirty minutes of infusion, and persisted for one hour. After discontinuing the offending drug and giving intravenous diphenhydramine and hydrocortisone, the patient’s visual acuity gradually recovered and was finally discharged. We also discuss the etiology and review the management of cefpirome-induced amaurosis fugax.