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Related Experiment Videos

Vancomycin-induced toxic epidermal necrolysis.

B A Hannah1, P L Kimmel, S Dosa

  • 1Department of Medicine, George Washington University Medical Center, Washington, DC 20037.

Southern Medical Journal
|June 1, 1990
PubMed
Summary
This summary is machine-generated.

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Vancomycin use in a renal transplant patient led to toxic epidermal necrolysis, a severe skin reaction. Prompt recognition and steroid treatment were crucial for managing this adverse drug event.

Area of Science:

  • Nephrology
  • Dermatology
  • Pharmacology

Background:

  • End-stage renal disease (ESRD) necessitates renal transplantation.
  • Post-transplant infections are common and require antibiotic treatment.
  • Intravenous antibiotics like vancomycin are frequently used in transplant recipients.

Observation:

  • A patient with a history of renal transplantation developed fever and presumed sepsis.
  • Treatment involved intravenous tobramycin and vancomycin.
  • The patient subsequently presented with persistent fever, eosinophilia, and a progressive maculopapular rash evolving into linear bullae.

Findings:

  • Skin biopsy findings were consistent with toxic epidermal necrolysis (TEN).
  • Measurable serum vancomycin concentrations were sustained.

Related Experiment Videos

  • The temporal relationship between vancomycin exposure and symptom onset, along with a positive response to steroid therapy, strongly implicated vancomycin.

    • Implications:

    • Vancomycin can induce severe cutaneous adverse drug reactions, including TEN, in renal transplant recipients.
    • Close monitoring for adverse effects is essential during vancomycin therapy in immunocompromised patients.
    • Early recognition and management with corticosteroids may improve outcomes in vancomycin-induced TEN.