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Oxacillin-induced leukocytoclastic vasculitis
Meric Mericliler1,2, Aya Shnawa2,3,4, Dalya Al-Qaysi1,2
1St. Elizabeth's Medical Center, Department of Medicine, Brighton, MA 02135.
Idcases
|August 7, 2019
Summary
This case study highlights a rare instance of leukocytoclastic vasculitis (LCV) triggered by the antibiotic oxacillin. Drug-induced LCV can manifest as skin purpura, emphasizing the importance of considering medication adverse effects.
Area of Science:
- Dermatology
- Rheumatology
- Pharmacology
Background:
- Leukocytoclastic vasculitis (LCV) is a histopathological pattern of small vessel inflammation.
- Cutaneous LCV often presents as palpable purpura on the lower extremities.
- While often idiopathic, LCV can be drug-induced, with beta-lactams frequently implicated.
Observation:
- A 32-year-old female developed palpable purpura on her hands and lower limbs.
- The symptoms appeared 12 days after initiating oxacillin for infective endocarditis.
- Skin biopsy confirmed leukocytoclastic vasculitis.
Findings:
- The patient's presentation and biopsy results were consistent with LCV.
- A strong temporal association suggested oxacillin as the causative agent.
- Discontinuation of oxacillin led to the resolution of skin lesions.
Implications:
- This case suggests oxacillin can induce cutaneous LCV.
- It underscores the importance of considering drug-induced vasculitis in differential diagnosis.
- This is the second reported case of oxacillin-induced cutaneous LCV, adding to the literature.
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