Abstract
BackgroundRapid intravenous administration of vancomycin may manifest with histaminergic responses with clinical features ranging from mild rashes, pruritus and even shock. This case reports of a child, who was accidentally given intravenous vancomycin within minutes and had a cardiac arrest.Case presentationA 9-year-old Asian girl who was scheduled for a limb salvage surgery, received vancomycin preoperatively. As a result of rapid infusion of the drug, the patient developed flushing, pruritus and had respiratory distress with hypotension leading to asystole. However, prompt detection and immediate cardiopulmonary resuscitation revived the patient in time following which sound recovery ensued. We recognised inadvertent brisk infusion of vancomycin as the culprit with strong suspicion of Red Man Syndrome.ConclusionRed Man Syndrome, though rarely encountered, can always be life threatening. With a surge in the use of vancomycin, adverse effects associated with its use also rises. So a comprehensive knowledge regarding its rationale use, adverse effects and its prompt management in personnel prescribing it, can be life saving.
Highlights
Rapid intravenous administration of vancomycin may manifest with histaminergic responses with clinical features ranging from mild rashes, pruritus and even shock
With a surge in the use of vancomycin, adverse effects associated with its use rises
Vancomycin is one such antibiotic that is used for both prevention and treatment of infections caused by gram-positive bacteria predominantly staphylococcal infections, which is commonly encountered in orthopedic practice
Summary
Rapid intravenous administration of vancomycin may manifest with histaminergic responses with clinical features ranging from mild rashes, pruritus and even shock. Case presentation: A 9-year-old Asian girl who was scheduled for a limb salvage surgery, received vancomycin preoperatively. The use of intravenous vancomycin demands extreme caution, as accidental rapid infusion can precipitate Red Man Syndrome (RMS) that can be life-threatening, if not identified and managed aptly. In this case report, we aim to highlight this rare and yet dreadful adverse effect of vancomycin, that can occur in daily clinical practice. Case presentation We recount of a 9-year-old Asian girl diagnosed with Ewing’s sarcoma of left distal tibia She had received six cycles of chemotherapy that had reduced the size of periosteal lesion compared to few months back. Following a routine pre-anesthetic assessment, she was cleared for surgery
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