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Case Reports
. 2018 Nov 6:14:73.
doi: 10.1186/s13223-018-0293-2. eCollection 2018.

Rash induced by enteral vancomycin therapy in an older patient in a long-term care ventilator unit: case report and review of the literature

Jeremy Barron  1   2 , Adolfo Lattes  1 , Esther-Lee Marcus  1
Affiliations
Case Reports

Rash induced by enteral vancomycin therapy in an older patient in a long-term care ventilator unit: case report and review of the literature

Jeremy Barron et al. Allergy Asthma Clin Immunol. .

Abstract

Background: Oral vancomycin is a first-line treatment for severe Clostridium difficile colitis. Oral vancomycin is perceived to lack systemic absorption or systemic adverse effects; however, a few cases of hypersensitivity to oral vancomycin have been reported, all in hospitalized patients.

Case presentation: In the present case, a 66-year-old woman with end-stage neurodegenerative disease residing in a long-term care facility developed a maculopapular rash following treatment with enteral vancomycin for recurrent C. difficile colitis. The rash resolved after withdrawal of the drug.

Conclusion: Rashes associated with oral vancomycin treatment include maculopapular rash, urticaria, red man syndrome, and linear IgA bullous dermatitis. Risk factors for systemic vancomycin absorption include renal insufficiency, severe intestinal inflammation, and high vancomycin dose and duration. Routine serum testing of vancomycin levels, even in these high risk cases, is not recommended. Clinicians should be aware that enteral vancomycin can cause hypersensitivity reactions which may be serious.

Keywords: Clostridium difficile colitis; Drug hypersensitivity; Vancomycin.

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References

    1. Simor AE. Diagnosis, management, and prevention of Clostridium difficile infection in long-term care facilities: a review. J Am Geriatr Soc. 2010;58:1556–1564. doi: 10.1111/j.1532-5415.2010.02958.x. - DOI - PubMed
    1. Bailey P, Gray H. An elderly woman with ‘Red Man Syndrome’ in association with oral vancomycin therapy: a case report. Cases J. 2008;1:111. doi: 10.1186/1757-1626-1-111. - DOI - PMC - PubMed
    1. Baumgartner LJ, Brown L, Geier C. Hypersensitivity reaction following administration of low-dose oral vancomycin for the treatment of Clostridium difficile in a patient with normal renal function. J Pharm Pract. 2017;30:650–2. doi: 10.1177/0897190016668437. - DOI - PubMed
    1. Bergeron L, Boucher FD. Possible red-man syndrome associated with systemic absorption of oral vancomycin in a child with normal renal function. Ann Pharmacother. 1994;28:581–584. doi: 10.1177/106002809402800505. - DOI - PubMed
    1. Bossé D, Lemire C, Ruel J, Cantin AM, Menard F, Valiquette L. Severe anaphylaxis caused by orally administered vancomycin to a patient with Clostridium difficile infection. Infection. 2013;41:579–582. doi: 10.1007/s15010-012-0328-4. - DOI - PubMed

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