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Stevens-Johnson-type reaction with vancomycin treatment.

C T Laurencin¹, R F Horan, P B Senatus

¹Harvard Medical School, Boston, MA.

The Annals of Pharmacotherapy

|December 1, 1992

Summary

Vancomycin can cause Stevens-Johnson syndrome, a severe skin reaction. Promptly stopping vancomycin treatment led to symptom resolution in a patient with rheumatoid arthritis.

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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.

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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.