Vancomycin‐induced vasculitis

Rawlinson, William D.; Cr, George

doi:10.5694/j.1326-5377.1987.tb133627.x

Cited by 6 publications

(3 citation statements)

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“…Several cases of vasculitis following vancomycin treatment have been reported in the literature: five cases of isolated leucocytoclastic cutaneous vasculitis [ 5 - 8 ] and one case of lupus-like syndrome [ 9 ]. To the best of our knowledge, only one case of HSP linked to vancomycin has been described previously [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Vancomycin-induced Henoch-Schönlein purpura: a case report

et al. 2012

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Introduction Henoch-Schönlein purpura is a small-vessel systemic vasculitis. Although its exact pathophysiology remains unknown, Henoch-Schönlein purpura has been reported in association with various medical conditions including hypersensitivity. We report the case of a patient with vancomycin-induced Henoch-Schönlein purpura. Case presentation A 42-year-old Caucasian man who had previously undergone a heart transplant was diagnosed as having an intra-abdominal abscess after he underwent a Hartmann procedure. At 15 days after initiation of antibiotic therapy including vancomycin, he developed a purpuric rash of the lower limbs, arthralgia, and macroscopic hematuria. At that time, our patient was already on hemodialysis for end-stage renal disease. Henoch-Schönlein purpura was diagnosed. After a second 15-day course of vancomycin, a second flare of Henoch-Schönlein purpura occurred. Skin biopsies showed leucocytoclastic vasculitis with IgA deposits and eosinophils in the peri-capillary inflammatory infiltrate, suggesting an allergic mechanism. After vancomycin was stopped, we did not observe any further flares. Only five cases of isolated cutaneous vasculitis, one case of lupus-like syndrome and one case of Henoch-Schönlein purpura after vancomycin treatment have been described to date in the literature. Conclusions Clinicians should be aware that systemic vasculitis can be induced by some treatments. Vancomycin is a widely prescribed antibiotic. Occurrence of rare but serious Henoch-Schönlein purpura associated with vancomycin requires its prompt discontinuation.

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Section: Discussionmentioning

confidence: 99%

Vancomycin-induced Henoch-Schönlein purpura: a case report

et al. 2012

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“…Vancomycin-related leukocytoclastic vasculitis has rarely been reported [ 6 – 9 ]. From previous published case reports, vancomycin-associated small vessel vasculitis can develop after only a single dose of vancomycin [ 6 ]. The onset of vasculitis can occur as late as one month after administration [ 7 , 8 ].…”

Section: Case Report and Discussionmentioning

confidence: 99%

Vancomycin-Associated Leukocytoclastic Vasculitis

Pongruangporn

Ritchie

et al. 2011

Case Reports in Infectious Diseases

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Vancomycin is U.S. Food and Drug Administration (FDA) approved for treatment of serious infections caused by methicillin-resistant Staphylococcus aureus (MRSA) or in individuals who have failed, cannot tolerate, or are allergic to other antibiotics. Very few cases of vancomycin-associated leukocytoclastic vasculitis have been published. We report on a patient who developed pruritus and palpable purpura in both lower extremities after receiving six days of intravenous vancomycin. Skin biopsy revealed leukocytoclastic vasculitis.

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“…Literature searches of both MEDLINE (1950-present) and Web of Knowledge (1900present) using the terms vancomycin, vasculitis, leukocytoclastic vasculitis, and allergic cutaneous vasculitis were conducted and revealed five published case reports of vancomycin-associated vasculitis ( Table 1). [5][6][7][8] Based on these published reports, the onset of vancomycin-associated vasculitis is highly variable, ranging from within 24 hours after drug initiation to 6 days after completion of a 21-day course of therapy. The adverse event does not appear to be dose related.…”

Section: Discussionmentioning

confidence: 99%

Vancomycin‐Induced Leukocytoclastic Vasculitis

Felix-Getzik

Sylvia

2009

Pharmacotherapy

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Vancomycin is well recognized as causing the nonallergic skin reaction known as red man syndrome; however, it is rarely suspected as causative in the setting of an immune-mediated skin reaction. We describe a 76-year-old Caucasian woman with a history of penicillin and sulfa allergies who was transferred to our medical center while receiving vancomycin for treatment of persistent methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia. After admission, the patient's pacemaker was explanted; cultures from the pacemaker grew MSSA. Based on the culture data and her allergy to penicillin, vancomycin was continued. On day 4 of therapy, the patient developed a papular rash with small blisters on her distal upper extremities. Furosemide, which she was receiving intermittently to maintain fluid balance, was initially suspected as the likely cause. Furosemide was withheld; however, the rash worsened and spread to her neck and torso. Results of skin biopsy confirmed a severe leukocytoclastic, necrotizing small-cell vasculitis that met the criteria for a hypersensitivity vasculitis associated with drug therapy. Five days after discontinuation of vancomycin, the vasculitis was resolving and continued to resolve throughout the remainder of her hospitalization. Furosemide was readministered without worsening of the vasculitis. Use of the Naranjo adverse drug reaction probability scale indicated that the likelihood of vancomycin being the cause of the vasculitis was probable (score of 5). Clinicians should be aware of vancomycin as a potential cause of small-vessel vasculitis.

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Vancomycin‐induced vasculitis

Cited by 6 publications

References 0 publications

Vancomycin-induced Henoch-Schönlein purpura: a case report

Vancomycin-induced Henoch-Schönlein purpura: a case report

Vancomycin-Associated Leukocytoclastic Vasculitis

Vancomycin‐Induced Leukocytoclastic Vasculitis

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