Inhaled vancomycin-induced allergic reaction in decontamination of respiratory tracts for allogeneic bone marrow transplantation.
A 34-year-old male suffered from an allergic reaction after inhalation of decontaminating drugs for BMT. Clinical challenge tests were undertaken to determine the causal drug. It was found that vancomycin hydrochloride (VCM) repeatedly induced dyspnea, fever, hypoxia, eosinophilia, and elevation of CRP. Therefore, clindamycin (CLDM) was used instead of VCM for decontamination of patient respiratory tract. Although complete decontamination of the respiratory tract was not achieved during the leukocytopenic period, BMT was successful, and there were no life-threatening infectious complications. Although inhaled VCM-induced allergic reaction may be a very rare complication in the BMT setting, careful clinical attention should be paid to such patients.
Kahata
K
K
Third Department of Internal Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
Hashino
S
S
Imamura
M
M
Mori
A
A
Kobayashi
S
S
Asaka
M
M
D000280:Administration, Inhalation; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D004342:Drug Hypersensitivity / Q000209:etiology*; D004359:Drug Therapy, Combination / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000150:complications / Q000628:therapy; D007958:Leukocyte Count; D008297:Male; D012129:Respiratory Function Tests; D019172:Transplantation Conditioning / Q000009:adverse effects*; D014184:Transplantation, Homologous; D014640:Vancomycin / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D014640:Vancomycin