Vancomycin-induced DRESS syndrome in a female patient

被引:43
作者
Vauthey, Laetitia [2 ]
Uckay, Ilker [1 ,2 ]
Abrassart, Sophie [2 ]
Bernard, Louis [3 ,4 ]
Assal, Mathieu [2 ]
Ferry, Tristan [1 ]
Djordjevic, Marina [5 ]
Roussos, Constantinos [2 ]
Vaudaux, Pierre [1 ]
机构
[1] Univ Hosp, Infect Dis Serv, CH-1211 Geneva, Switzerland
[2] Univ Hosp, Orthopaed Surg Serv, CH-1211 Geneva, Switzerland
[3] Raymond Poincare Univ Hosp, Infect Dis Serv, Garches, France
[4] Publ Assistance Hosp Paris, Garches, France
[5] Ctr Clin, Nish, Serbia
关键词
DRESS syndrome; vancomycin; drug rash; drug hypersensitivity; eosinophilia;
D O I
10.1159/000142729
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Background: DRESS syndrome (drug rash with eosinophilia and systemic symptoms) is a hypersensitivity reaction with skin rashes, eosinophilia, fever, lymph node enlargement and internal organ involvement. Case Report: A 60-year-old diabetic woman was hospitalized at the University Hospitals of Geneva for mid-leg amputation due to peripheral arterial occlusive disease. No drug allergy was reported. Because of a wound infection by methicillin-resistant Staphylococcus aureus, treatment with vancomycin (2 g/day) in continuous perfusion was initiated. Approximately 2 weeks later, she developed a toxidermia with fever, a progressive maculopapular skin rash, eosinophilia and acute renal insufficiency. The skin biopsy revealed a necrosis with lymphocytic and eosinophilic infiltrations, supporting the suspicion of DRESS syndrome. A cure was achieved by the withdrawal of vancomycin and the administration of methylprednisolone (1 g/day), antihistaminics and topical mometasone, without the introduction of other antibiotics. Conclusion: Vancomycin can be a cause of DRESS syndrome. A high index of suspicion is warranted in order not to miss this potentially lethal disease. Copyright (C) 2008 S. Karger AG, Basel.
引用
收藏
页码:138 / 141
页数:4
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