Skip to main content

Advertisement

SpringerLink
Log in

Severe anaphylaxis caused by orally administered vancomycin to a patient with Clostridium difficile infection

  • Case Report
  • Published:
Infection Aims and scope Submit manuscript

Abstract

We report the first case of anaphylaxis to oral vancomycin in a cystic fibrosis patient with severe and relapsing Clostridium difficile infection (CDI) refractory to metronidazole. The patient’s colitis has been successfully treated with a combination of intravenous metronidazole and tigecycline.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Cohen SH, Gerding DN, Johnson S, et al. Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA). Infect Control Hosp Epidemiol. 2010;31:431–55.

    Article  PubMed  Google Scholar 

  2. Bauer MP, Kuijper EJ, van Dissel JT; European Society of Clinical Microbiology and Infectious Diseases. European Society of Clinical Microbiology and Infectious Diseases (ESCMID): treatment guidance document for Clostridium difficile infection (CDI). Clin Microbiol Infect. 2009;15:1067–79.

    Article  PubMed  CAS  Google Scholar 

  3. Gonzales M, Pepin J, Frost EH, et al. Faecal pharmacokinetics of orally administered vancomycin in patients with suspected Clostridium difficile infection. BMC Infect Dis. 2010;10:363.

    Article  PubMed  CAS  Google Scholar 

  4. Osawa R, Kaka AS. Maculopapular rash induced by oral vancomycin. Clin Infect Dis. 2008;47:860–1.

    Article  PubMed  Google Scholar 

  5. Bailey P, Gray H. An elderly woman with ‘Red Man Syndrome’ in association with oral vancomycin therapy: a case report. Cases J. 2008;1:111.

    Article  PubMed  Google Scholar 

  6. Bergeron L, Boucher FD. Possible red-man syndrome associated with systemic absorption of oral vancomycin in a child with normal renal function. Ann Pharmacother. 1994;28:581–4.

    PubMed  CAS  Google Scholar 

  7. Renz CL, Laroche D, Thurn JD, et al. Tryptase levels are not increased during vancomycin-induced anaphylactoid reactions. Anesthesiology. 1998;89:620–5.

    Article  PubMed  CAS  Google Scholar 

  8. Ebo DG, Verheecke G, Bridts CH, Mertens CH, Stevens WJ. Perioperative anaphylaxis from locally applied rifamycin SV and latex. Br J Anaesth. 2006;96:738–41.

    Article  PubMed  CAS  Google Scholar 

  9. Greenberg K, Espinosa J, Scali V. Anaphylaxis to topical bacitracin ointment. Am J Emerg Med. 2007;25:95–6.

    Article  PubMed  Google Scholar 

  10. Saryan JA, Dammin TC, Bouras AE. Anaphylaxis to topical bacitracin zinc ointment. Am J Emerg Med. 1998;16:512–3.

    Article  PubMed  CAS  Google Scholar 

  11. Scala E, Giani M, Pirrotta L, Guerra EC, De Pità O, Puddu P. Multiple drug allergy syndrome: severe anaphylactic reaction due to topical rifamycin SV in a patient with hypersensitivity to ciprofloxacin. Int J Dermatol. 2001;40:603–4.

    Article  PubMed  CAS  Google Scholar 

  12. Taylor SL, Hefle SL, Bindslev-Jensen C, et al. Factors affecting the determination of threshold doses for allergenic foods: how much is too much? J Allergy Clin Immunol. 2002;109:24–30.

    Article  PubMed  Google Scholar 

  13. Crespo JF, Pascual C, Dominguez C, Ojeda I, Muñoz FM, Esteban MM. Allergic reactions associated with airborne fish particles in IgE-mediated fish hypersensitive patients. Allergy. 1995;50:257–61.

    Article  PubMed  CAS  Google Scholar 

  14. Ramesh S. Antibiotic hypersensitivity in patients with CF. Clin Rev Allergy Immunol. 2002;23:123–41.

    Article  PubMed  CAS  Google Scholar 

  15. Pham NH, Baldo BA, Puy RM. Studies on the mechanism of multiple drug allergies. Structural basis of drug recognition. J Immunoassy Immunochem. 2001;22:47–73.

    Article  CAS  Google Scholar 

  16. Cheong EY, Gottlieb T. Intravenous tigecycline in the treatment of severe recurrent Clostridium difficile colitis. Med J Aust. 2011;194:374–5.

    PubMed  Google Scholar 

  17. Herpers BL, Vlaminckx B, Burkhardt O, et al. Intravenous tigecycline as adjunctive or alternative therapy for severe refractory Clostridium difficile infection. Clin Infect Dis. 2009;48:1732–5.

    Article  PubMed  CAS  Google Scholar 

  18. Lu CL, Liu CY, Liao CH, Huang YT, Wang HP, Hsueh PR. Severe and refractory Clostridium difficile infection successfully treated with tigecycline and metronidazole. Int J Antimicrob Agents. 2010;35:311–2.

    Article  PubMed  CAS  Google Scholar 

  19. El-Herte RI, Baban TA, Kanj SS. Recurrent refractory Clostridium difficile colitis treated successfully with rifaximin and tigecycline: a case report and review of the literature. Scand J Infect Dis. 2012;44:228–30.

    Article  PubMed  CAS  Google Scholar 

  20. Kopterides P, Papageorgiou C, Antoniadou A, et al. Failure of tigecycline to treat severe Clostridium difficile infection. Anaesth Intensive Care. 2010;38:755–8.

    PubMed  CAS  Google Scholar 

  21. Cornely OA, Miller MA, Louie TJ, Crook DW, Gorbach SL. Treatment of first recurrence of Clostridium difficile infection: fidaxomicin versus vancomycin. Clin Infect Dis. 2012; 55 Suppl 2:S154–61.

    Article  PubMed  CAS  Google Scholar 

  22. Louie TJ, Cannon K, Byrne B, et al. Fidaxomicin preserves the intestinal microbiome during and after treatment of Clostridium difficile infection (CDI) and reduces both toxin re-expression and recurrence of CDI. Clin Infect Dis. 2012; 55 Suppl 2:S132–42.

    Article  PubMed  CAS  Google Scholar 

  23. Louie TJ, Emery J, Krulicki W, Byrne B, Mah M. OPT-80 eliminates Clostridium difficile and is sparing of bacteroides species during treatment of C. difficile infection. Antimicrob Agents Chemother. 2009;53(1):261–3.

    Article  PubMed  CAS  Google Scholar 

  24. Nerandzic MM, Mullane K, Miller MA, Babakhani F, Donskey CJ. Reduced acquisition and overgrowth of vancomycin-resistant enterococci and candida species in patients treated with fidaxomicin versus vancomycin for Clostridium difficile infection. Clin Infect Dis. 2012;55 Suppl 2:S121–6.

    Article  PubMed  CAS  Google Scholar 

  25. Al-Nassir WN, Sethi AK, Li Y, Pultz MJ, Riggs MM, Donskey CJ. Both oral metronidazole and oral vancomycin promote persistent overgrowth of vancomycin-resistant enterococci during treatment of Clostridium difficile-associated disease. Antimicrob Agents Chemother. 2008;52(7):2403–6.

    Article  PubMed  CAS  Google Scholar 

  26. Liss BJ, Vehreschild JJ, Cornely OA, et al. Intestinal colonisation and blood stream infections due to vancomycin-resistant enterococci (VRE) and extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBLE) in patients with haematological and oncological malignancies. Infection. 2012. doi:10.1007/s15010-012-0269-y

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Medicine, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada

    D. Bossé, J. Ruel & A. M. Cantin

  2. Department of Microbiology-Infectious Diseases, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, J1H 5N4, Canada

    F. Ménard & L. Valiquette

  3. Immunology and Allergy Division, Department of Pediatrics, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada

    C. Lemire

Authors
  1. D. Bossé
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Lemire
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. Ruel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. M. Cantin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. F. Ménard
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. L. Valiquette
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D. Bossé.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bossé, D., Lemire, C., Ruel, J. et al. Severe anaphylaxis caused by orally administered vancomycin to a patient with Clostridium difficile infection. Infection 41, 579–582 (2013). https://doi.org/10.1007/s15010-012-0328-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s15010-012-0328-4

Keywords

Search

Navigation