Stevens-Johnson-type reaction with vancomycin treatment

Area of Science:

• Dermatology
• Pharmacology
• Rheumatology

Background:

• Stevens-Johnson syndrome (SJS) is a severe, acute mucocutaneous disease with high mortality.
• The pathogenesis of SJS remains poorly understood.
• Vancomycin is an antibiotic commonly used for serious infections.

Observation:

• A 71-year-old woman with rheumatoid arthritis developed SJS.
• The patient was receiving vancomycin for an infected cervical fusion site.
• Classic SJS symptoms included target lesions and erosive mucosal involvement.

Findings:

• Vancomycin was identified as the likely causative agent of SJS in this patient.
• Discontinuation of vancomycin resulted in the patient's eventual recovery.
• This case highlights an uncommon but serious adverse reaction to vancomycin.

Implications:

• Vancomycin should be considered a potential cause of Stevens-Johnson syndrome.
• Clinicians should maintain a high index of suspicion for SJS in patients on vancomycin.
• Early recognition and drug withdrawal are crucial for managing SJS.