Life-Threatening Reaction to Vancomycin Given for Noninfectious Fever

Abstract

Even with cautious slow infusion, intravenous vancomycin can precipitate life-threatening infusion-related reactions in some patients. Because of this, and to reduce selective pressure for vancomycin resistance, sources of fever that do not require treatment with vancomycin should be diligently investigated prior to the institution of empiric vancomycin therapy in febrile patients, particularly when the past medical history is suggestive of an alternative diagnosis.

Positive patch test in vancomycin allergy

“…The commonest adverse effects of vancomycin are the “red man syndrome” (2, 3) and spasms and muscular pains (4), both due to histamine release related to its rapid infusion. Among other well‐known side‐effects (5, 6) are hypersensitivity reactions such as maculopapular rash, urticaria, drug fever (5), vasculitis (7), anaphylaxis (8, 9), IgA bullous dermatosis (10) and Stevens‐Johnson syndrome or toxic epidermal necrolysis (4, 11).…”