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"Getting Under Your Skin": First Reported Case of Transient Reactive Phlebitis Involving Vancomycin Infusion Therapy.

Obteene Azimi-Ghomi1, Andrew Napier2

  • 1Department of General Surgery, Kendall Regional Medical Center, Miami, USA.

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|November 10, 2021
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Summary

A patient experienced a unique rash along her IV line after receiving vancomycin for diverticulitis. This reaction, known as transient reactive phlebitis, highlights a rare side effect of this common antibiotic.

Keywords:
phlebitisrashtransient reactive phlebitisvancomycinvermiform

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Area of Science:

  • Dermatology
  • Infectious Diseases
  • Pharmacology

Background:

  • Diverticulitis is a common condition often treated with oral antibiotics.
  • Intravenous (IV) vancomycin is used for complicated or resistant infections.
  • Cutaneous drug reactions can occur with vancomycin therapy.

Observation:

  • A 54-year-old female with uncomplicated diverticulitis developed a rash after IV vancomycin.
  • The rash was atopic and vermiform, ascending along the venous distribution of the left arm.
  • The rash was localized proximal to the vancomycin IV infusion site.

Findings:

  • The observed reaction is consistent with transient reactive phlebitis (TRP).
  • TRP is a rare, localized cutaneous drug reaction associated with IV vancomycin.
  • This case adds to the literature on vancomycin-associated cutaneous drug reactions.

Implications:

  • Clinicians should be aware of transient reactive phlebitis as a potential side effect of IV vancomycin.
  • Recognition of TRP can prevent misdiagnosis and unnecessary escalation of care.
  • Further research into the mechanisms and management of vancomycin-induced phlebitis is warranted.