en
Scientific article
English

Vancomycin-induced DRESS syndrome in a female patient

Published inPharmacology, vol. 82, no. 2, p. 138-141
Publication date2008
Abstract

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.

Keywords
  • Anti-Allergic Agents/therapeutic use
  • Anti-Bacterial Agents/adverse effects
  • Drug Eruptions/etiology
  • Eosinophilia/chemically induced
  • Female
  • Fever/chemically induced
  • Glucocorticoids/therapeutic use
  • Humans
  • Methylprednisolone/therapeutic use
  • Middle Aged
  • Pregnadienediols/therapeutic use
  • Renal Insufficiency, Acute/chemically induced
  • Syndrome
  • Vancomycin/adverse effects
Citation (ISO format)
VAUTHEY, Laetitia et al. Vancomycin-induced DRESS syndrome in a female patient. In: Pharmacology, 2008, vol. 82, n° 2, p. 138–141. doi: 10.1159/000142729
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Article (Accepted version)
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ISSN of the journal1423-0313
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