PDF(Pubmed)
Abstract：
Vancomycin is a bactericidal antibiotic used for various infections but can cause hypersensitivity reactions, including vancomycin flushing syndrome (VFS) and anaphylaxis. VFS, previously known as red man syndrome, is a pseudoallergic reaction characterized by flushing, erythema, and pruritus. We present a case of VFS in a female patient with recurrent Methicillin-resistant Staphylococcus aureus (MRSA) infections receiving vancomycin for back abscesses. Following the second dose, she developed a pruritic rash on her face, neck, and torso, which resolved with treatment. The differential diagnosis included hydromorphone allergy, ruled out due to previous tolerance. Anaphylaxis was unlikely due to the absence of respiratory distress, hypotension, or angioedema. Management involved discontinuing vancomycin, administering corticosteroids and antihistamines, and monitoring for anaphylaxis. The patient was transferred for surgical intervention and alternative antibiotic therapy. This case highlights the importance of recognizing and managing VFS, the significance of differential diagnoses, and the need for enhanced documentation and clinical support in managing vancomycin hypersensitivity reactions.
摘要：
万古霉素是一种用于各种感染的杀菌抗生素，但可引起超敏反应，包括万古霉素冲洗综合征（VFS）和过敏反应。VFS,以前被称为红人综合症，是一种以潮红为特征的假性过敏反应，红斑,还有瘙痒.我们介绍了一例复发性耐甲氧西林金黄色葡萄球菌（MRSA）感染的女性患者的VFS病例，该患者接受万古霉素治疗背部脓肿。第二次给药后,她脸上出现了瘙痒性皮疹,脖子,和躯干,通过治疗解决。鉴别诊断包括氢吗啡酮过敏，由于先前的宽容而被排除在外。由于没有呼吸窘迫，过敏反应不太可能发生，低血压,或血管性水肿。管理涉及停用万古霉素，服用皮质类固醇和抗组胺药，和监测过敏反应。患者被转移接受手术干预和替代抗生素治疗。这个案例强调了识别和管理VFS的重要性，鉴别诊断的意义，以及在管理万古霉素超敏反应方面需要加强文件和临床支持。
