A case of hypersensitivity syndrome to both vancomycin and teicoplanin
A case of hypersensitivity syndrome to both vancomycin and teicoplanin
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DOI：
10.3346/jkms.2006.21.6.1108
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发表时间：
2006-12-01
影响因子：
4.5
通讯作者：
Min, Kyung-Up
中科院分区：
文献类型：
--
作者：
Kwon, Hyouk-Soo;Chang, Yoon-Seok;Min, Kyung-Up
对万古霉素和替可普宁的药物过敏综合征以前没有报道。我们在此报告一位患有椎体骨髓炎和硬膜外脓肿的50岁男性患者，他对万古霉素和替柯planin都产生了过敏综合征。在给药后出现皮疹、发热、嗜酸性粒细胞增多、间质性肺炎和间质性肾炎，在停药和高剂量皮质类固醇治疗后消退。6周疗程的利奈唑胺成功治疗椎体骨髓炎，无其他并发症。恢复2个月后进行万古霉素和替可普宁皮肤贴试验；万古霉素的弱阳性结果（10% aq, D2 +, D4 +，伴有红斑和囊泡；ICDRG评分），替柯planin的结果可疑（4% aq.- D2和+/- D4，伴有黄斑红斑；ICDRG评分）。我们提出这个病例是为了提醒临床医生注意万古霉素和替柯planin可能导致的过敏综合征，可能有交叉反应，这可能危及生命。
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, an 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.