title: A case of hypersensitivity syndrome to both vancomycin and teicoplanin.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, 28 Yongun-Dong Chongno-Gu, Seoul, Korea.
authors.forename: Hyouk-Soo
authors.initials: HS
authors.lastname: Kwon
authors.forename: Yoon-Seok
authors.initials: YS
authors.lastname: Chang
authors.forename: Yi-Yeong
authors.initials: YY
authors.lastname: Jeong
authors.forename: Sang-Min
authors.initials: SM
authors.lastname: Lee
authors.forename: Woo-Jung
authors.initials: WJ
authors.lastname: Song
authors.forename: Hong-Bin
authors.initials: HB
authors.lastname: Kim
authors.forename: Yoon-Keun
authors.initials: YK
authors.lastname: Kim
authors.forename: Sang-Heon
authors.initials: SH
authors.lastname: Cho
authors.forename: You-Young
authors.initials: YY
authors.lastname: Kim
authors.forename: Kyung-Up
authors.initials: KU
authors.lastname: Min
mesh_terms: 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*
chemical_list: D004338:Drug Combinations; D017334:Teicoplanin; D014640:Vancomycin