A case of hypersensitivity syndrome to both vancomycin and teicoplanin.
Drug hypersensitivity syndrome to both vancomycin and teicoplanin has not been previously reported. We describe here a 50-yr-old male patient with vertebral osteomyelitis and epidural abscess who developed hypersensitivity syndrome to both vancomycin and teicoplanin. Skin rash, fever, eosinophilia, interstitial pneumonitis, and interstitial nephritis developed following the administration of each drug, and resolved after withdrawing the drugs and treating with high dose corticosteroids. The vertebral osteomyelitis was successfully treated with 6-week course of linezolid without further complications. Skin patch tests for vancomycin and teicoplanin was done 2 months after the recovery; a weak positive result for vancomycin (10% aq.,+at D2 and +at D4 with erythema and vesicles; ICDRG scale), and a doubtful result for teicoplanin (4% aq.-at D2 and+/-at D4 with macular erythema; ICDRG scale). We present this case to alert clinicians to the hypersensitivity syndrome that can result from vancomycin and teicoplanin, with possible cross-reactivity, which could potentially be life-threatening.
Kwon
Hyouk-Soo
HS
Department of Internal Medicine, Seoul National University College of Medicine, 28 Yongun-Dong Chongno-Gu, Seoul, Korea.
Chang
Yoon-Seok
YS
Jeong
Yi-Yeong
YY
Lee
Sang-Min
SM
Song
Woo-Jung
WJ
Kim
Hong-Bin
HB
Kim
Yoon-Keun
YK
Cho
Sang-Heon
SH
Kim
You-Young
YY
Min
Kyung-Up
KU
D004338:Drug Combinations; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013577:Syndrome; D017334:Teicoplanin / Q000009:adverse effects*; D014640:Vancomycin / Q000009:adverse effects*
D004338:Drug Combinations; D017334:Teicoplanin; D014640:Vancomycin