Immunoglobulin E-mediated hypersensitivity reaction after intraperitoneal administration of vancomycin.
Intraperitoneal (IP) vancomycin is widely used to treat Gram-positive peritonitis associated with peritoneal dialysis. There have been two cases of red man syndrome (RMS), a vancomycin-specific nonimmunologic reaction, associated with IP vancomycin. However, immune-mediated hypersensitivity reaction to IP vancomycin has not yet been reported. A 49 year old woman on continuous ambulatory peritoneal dialysis developed her first peritonitis episode. The patient was treated with IP vancomycin once/wk for 4 weeks. She experienced mild itching and flushing throughout her body for 1 day after the second treatment. Whenever vancomycin was administered, generalized urticaria and a prickling sensation developed, and the intensity increased gradually; however, these symptoms improved after vancomycin was discontinued. An allergic skin test was performed 6 weeks after the previous urticarial episode, and an intradermal skin test revealed a positive response to vancomycin. To our knowledge, this is the first case report of immunoglobulin E-mediated hypersensitivity reaction to IP vancomycin administration.
Division of Nephrology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea.
Mun-Ju
MJ
Hwang
Division of Nephrology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea.
Jun-Young
JY
Do
Division of Nephrology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea.
Eun-Woo
EW
Choi
Division of Nephrology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea.
Joon-Hyuk
JH
Seo
Division of Nephrology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea.
Yoon-Jung
YJ
Nam
Division of Nephrology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea.
Kyung-Woo
KW
Yoon
Division of Nephrology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea.
Jong-Won
JW
Park
Division of Nephrology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea.
Kyu-Hyang
KH
Cho
Division of Nephrology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea.
Seok-Hui
SH
Kang
Division of Pulmonology and Allergy, Regional Center for Respiratory Disease, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea.
Hyun-Jung
HJ
Jin
Hypersensitivity; Intraperitoneal administration; Peritoneal dialysis; Vancomycin