Forrence E A, Goldman M P
Pharmacy Service, Veterans Administration Medical Center, Cleveland, OH 44106.
DICP. 1990 Apr;24(4):369-71. doi: 10.1177/106002809002400405.
We describe a 51-year-old patient with endstage renal disease who developed vancomycin-associated exfoliative dermatitis. After four weeks of vancomycin hydrochloride treatment for staphylococcal pericarditis this patient developed a hypersensitivity reaction characterized by intermittent fevers, lymphadenopathy, peripheral eosinophilia, and exfoliative dermatitis. The reaction persisted for five weeks, probably because of inability to rapidly eliminate vancomycin secondary to underlying renal failure. Maculopapular rashes have been reported in two to six percent of patients who receive this drug, with severe skin reactions rarely reported. In addition to this case report, a review of the literature including 11 Eli Lilly/Food and Drug Administration case reports is presented. Although severe skin reactions to vancomycin rarely occur, they prolong morbidity, particularly in patients with renal failure.
我们描述了一名51岁的终末期肾病患者，该患者发生了万古霉素相关性剥脱性皮炎。在接受盐酸万古霉素治疗葡萄球菌性心包炎四周后，该患者出现了过敏反应，其特征为间歇性发热、淋巴结病、外周嗜酸性粒细胞增多和剥脱性皮炎。该反应持续了五周，可能是由于潜在的肾衰竭导致无法迅速清除万古霉素。据报道，接受该药治疗的患者中有2%至6%出现斑丘疹，严重皮肤反应的报道很少。除了本病例报告外，还对包括礼来公司/美国食品药品监督管理局的11份病例报告在内的文献进行了综述。尽管万古霉素引起的严重皮肤反应很少发生，但它们会延长发病时间，尤其是在肾衰竭患者中。
