Red man syndrome induced by vancomycin in a premature infant

Abstract

A 4-month-old premature infant with broncho-pulmonary dysplasia was hospitalized and received imipenem and cilastatin sodium combined with erythromycin for severe pneumonia. During hospitalization, erythromycin was stopped because of exacerbation of infection and replaced by vancomycin hydrochloride 60 mg dissolved in 5% glucose injection 15 ml by an IV infusion at a speed of 60 mg/h. About 10 minutes of vancomycin treatment, the infant developed cry and noisy and facial flushing. Then the infusion speed was slowed down, but the infant was still crying and his skin erythema increased, which gradually fused into pieces on his neck, chest and limbs. And his heart rate increased to 160 beats/min. Red man syndrome induced by vancomycin was considered. Vancomycin was stopped immediately and no antiallergic agents were given. About one hour later, the skin rash disappeared gradually and the heart rate decreased to 140 beats/min. The next day, the skin color returned to normal. Then teicoplanin combined with imipenem and cilastatin sodium were given according to the results of drug sensitivity test in sputum culture. The rash did not recur. Two weeks later, his pneumonia improved and he was discharged. Key words: Vancomycin; Infant, premature; Drug eruptions; Erythema; Red man syndrome