Shah Nikhil H, Kline Kristopher P, Shukla Manas K
Internal Medicine, University of Florida, Gainesville, Florida, USA.
Internal Medicine, Malcom Randall Veterans Affairs Medical Center, Gainesville, Florida, USA.
BMJ Case Rep. 2017 Jun 20;2017:bcr-2017-219988. doi: 10.1136/bcr-2017-219988.
A 59-year-old male presented with methicillin-resistant bacteraemia from a prostatic abscess and was treated with vancomycin. Two weeks into his treatment course, he developed severe joint pains, abdominal pain with bloody, mucinous stools and a diffuse palpable purpuric rash on his extremities. Biopsy of the rash showed IgA immune-complex deposition consistent with Henoch-Schönlein purpura. After treatment with glucocorticoids, his symptoms resolved completely. Vancomycin is an extremely commonly used antibiotic with certain well-known adverse effects. Henoch-Schönlein purpura, a vasculitis involving abdominal pain, arthralgias and palpable purpura, is a much less common side effect, as seen in this patient. Given that vancomycin is widely used internationally, clinicians should be aware of the risks entailed by its use.
一名59岁男性因前列腺脓肿出现耐甲氧西林菌血症，接受万古霉素治疗。治疗过程两周后，他出现严重关节疼痛、腹痛伴血性黏液便，四肢出现弥漫性可触及的紫癜性皮疹。皮疹活检显示IgA免疫复合物沉积，符合过敏性紫癜。经糖皮质激素治疗后，他的症状完全缓解。万古霉素是一种极其常用的抗生素，有某些众所周知的不良反应。过敏性紫癜是一种累及腹痛、关节痛和可触及紫癜的血管炎，是一种较罕见的副作用，如该患者所示。鉴于万古霉素在国际上广泛使用，临床医生应意识到其使用所带来的风险。
