Immunoglobulin E-mediated hypersensitivity reaction after intraperitoneal administration of vancomycin

Immunoglobulin E-mediated hypersensitivity reaction after intraperitoneal administration of vancomycin

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Intraperitoneal Model Paint (IP) vancomycin is widely used to treat Gram-positive peritonitis associated with peritoneal dialysis.There have been two cases of red man syndrome (RMS), a vancomycin-specific nonimmunologic reaction, associated with IP vancomycin.However, immune-mediated hypersensitivity reaction to IP vancomycin has not yet been reported.

A 49 year old woman on continuous ambulatory peritoneal dialysis developed her first peritonitis episode.The patient was treated with IP vancomycin once/wk for 4 weeks.She experienced mild itching and flushing throughout her body for 1 day after the second treatment.

Whenever vancomycin was administered, generalized urticaria and a prickling sensation developed, and the intensity increased gradually; however, Sweatshirt these symptoms improved after vancomycin was discontinued.An allergic skin test was performed 6 weeks after the previous urticarial episode, and an intradermal skin test revealed a positive response to vancomycin.To our knowledge, this is the first case report of immunoglobulin E-mediated hypersensitivity reaction to IP vancomycin administration.