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Updated: Mar 14, 2026
12:23
Granulocyte-dependent Autoantibody-induced Skin Blistering
Published on: October 12, 2012
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Vancomycin-associated Henoch-Schönlein purpura
Zaw Min1, Raquel R Garcia1, Monika Murillo1
1Division of Infectious Disease, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA, USA.
Summary
Vancomycin can cause rare but serious skin reactions like IgA vasculitis. Promptly stopping the antibiotic is crucial for patient recovery and preventing potential kidney damage.
Area of Science:
- Dermatology
- Nephrology
- Infectious Diseases
Background:
- Intravenous vancomycin is a critical antibiotic for treating infections like methicillin-resistant Staphylococcus aureus.
- Vancomycin is associated with various cutaneous hypersensitivity reactions, including maculopapular rash, red-man syndrome, and severe conditions like Stevens-Johnson syndrome.
- Cutaneous reactions necessitate careful monitoring and prompt diagnosis to differentiate from other conditions.
Observation:
- An elderly patient with end-stage renal disease developed palpable purpura during vancomycin therapy.
- Skin biopsy revealed leukocytoclastic vasculitis with IgA and C3 deposition in vessel walls.
Findings:
- The patient was diagnosed with a vancomycin-associated Henoch-Schönlein variant of vasculitis.
- Switching to daptomycin resolved the purpuric rash, indicating vancomycin as the causative agent.
Implications:
- Clinicians should be aware of this rare vancomycin-induced vasculitis.
- Early recognition and vancomycin discontinuation are key management strategies.
- Re-challenge or desensitization is not recommended due to potential for severe recurrence.
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