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.
References
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.
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.
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.
Osawa R, Kaka AS. Maculopapular rash induced by oral vancomycin. Clin Infect Dis. 2008;47:860–1.
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.
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.
Renz CL, Laroche D, Thurn JD, et al. Tryptase levels are not increased during vancomycin-induced anaphylactoid reactions. Anesthesiology. 1998;89:620–5.
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.
Greenberg K, Espinosa J, Scali V. Anaphylaxis to topical bacitracin ointment. Am J Emerg Med. 2007;25:95–6.
Saryan JA, Dammin TC, Bouras AE. Anaphylaxis to topical bacitracin zinc ointment. Am J Emerg Med. 1998;16:512–3.
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.
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.
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.
Ramesh S. Antibiotic hypersensitivity in patients with CF. Clin Rev Allergy Immunol. 2002;23:123–41.
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.
Cheong EY, Gottlieb T. Intravenous tigecycline in the treatment of severe recurrent Clostridium difficile colitis. Med J Aust. 2011;194:374–5.
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.
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.
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.
Kopterides P, Papageorgiou C, Antoniadou A, et al. Failure of tigecycline to treat severe Clostridium difficile infection. Anaesth Intensive Care. 2010;38:755–8.
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.
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.
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.
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.
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.
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
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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
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DOI: https://doi.org/10.1007/s15010-012-0328-4