Probable hypersensitivity reaction to vancomycin associating rash, fever and neutropenia.
We describe the case of a 54-year old woman with breast cancer who was treated by vancomycin for febrile neutropenia due to a methicillin-resistant Staphyloccocus epidermidis infection of a surgically implanted catheter. She developed an hypersensitivity reaction to vancomycin associating neutropenia, fever, skin rash and elevated liver enzymes following re-challenge with vancomycin after having been misdiagnosed with septic thrombophlebitis. Following this re-challenge, neutrophils count fell dramatically but promptly resolved after cessation of vancomycin.
Oncology Clinic,Erasme University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium. ndauby@ulb.ac.be
N
N
Dauby
W
W
Fink
L
L
Seyler
S
S
Luce
C
C
Nouwynck
S
S
Tas
F
F
Jacobs
D000410:Alanine Transaminase / Q000097:blood; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001219:Aspartate Aminotransferases / Q000097:blood; D005076:Exanthema / Q000139:chemically induced*; D005260:Female; D005334:Fever / Q000139:chemically induced*; D006801:Humans; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced*; D014640:Vancomycin / Q000009:adverse effects*
D000900:Anti-Bacterial Agents; D014640:Vancomycin; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase