Serum Tryptase Cannot Differentiate Vancomycin-Induced Anaphylaxis From Red Man Syndrome
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To the Editor:
Perioperative anaphylaxis is a life-threatening event and requires prompt recognition and treatment to ensure a good outcome. Vancomycin can induce nonspecific direct stimulation of mast cells, resulting in histamine release and the anaphylactoid reaction known as “red man syndrome” . Red man syndrome and anaphylaxis share a number of signs and symptoms, and thus differential diagnosis is difficult in some cases. Nonetheless, differential diagnosis between these conditions is crucial, since a diagnosis of anaphylaxis to vancomycin reduces the options for treatment of life-threatening infections such as infective endocarditis, severe pneumonia, and sepsis. Measurement of the serum tryptase concentration is considered useful to distinguish between red man syndrome and anaphylaxis . However, we here report the case of a patient diagnosed as having anaphylaxis induced by intravenous vancomycin usage based on increased plasma tryptase concentration, despite a clinical...
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The authors declare that they have no conflict of interest.
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