A case of vancomycin-induced drug hypersensitivity syndrome

The drug hypersensitivity syndrome (DHS) is a severe, idiosyncratic multi-system reaction caused by drugs. It is defined by the clinical triad of fever, rash and internal organ involvement 1) . Vancomycin has rarely been reported as a cause of the DHS 2) . There are only a few cases of suspected DHS due to vancomycin previously reported in the medical literature 3-5) . In 1990, Hannah et al. 3) reported a patient who had renal transplantation for end-stage renal disease. This patient was treated for fever and presumed sepsis with intravenous tobramycin and vancomycin, with the subsequent development of persistent fever, eosinophilia and a maculopapular rash that progressed to linear bullae. Sustained measurable serum concentrations of vancomycin, the temporal response to the drug exposure and the response to steroid therapy suggested that vancomycin was the causative agent. Here, we describe a case of vancomycin-induced DHS in a patient receiving vancomycin for infective endocarditis.