A case of penicillin resistant pneumococcal meningitis who developed red neck syndrom due to vancomycin therapy

Year 2019, Volume: 2 Issue: 1, 34 - 37, 25.01.2019

Hüseyin Esmer Salih Cesur Çiğdem Ataman Hatipoğlu Esra Kaya Kılıç Sami Kınıklı Güler Vahaboğlu

https://doi.org/10.32322/jhsm.471102

Abstract

Red neck syndrome which is a
side effect of vancomycin, is associated with excessive release of histamine and
is sometimes a life threatening complication. In patients who develop
red
neck syndrome, if necessary, vancomycin therapy may be continued with
corticosteroids and antihistamines or an alternative antibiotic may be started.
In this report, a 54 year-old female patient who was
started vancomycin therapy because of penicillin resistant pneumococcal
meningitis and developed red neck syndrome on 8th day of the therapy was
presented. It was learned that the patient's vancomycin infusion that morning
was shorter than one hour. Vancomycin therapy was stopped and intravenous
linezolide was started. In conclusion, red neck syndrome may develop due to rapid
infusion of vancomycin. In this patients linezolide may be used as alternative
therapy. 

Keywords

Penicillin resistant pneumococcus, meningitis, vancomycin, side effect, red neck syndrome, , management

Vankomisin tedavisine bağlı olarak red neck sendromu gelişen penisiline dirençli pnömokok menenjiti olgusu

Abstract

Vankomisine bağlı olarak gelişen yan etkilerden
red neck (kırmızı boyun) sendromu histamin aşırı salınımına bağlı bazen hayatı
tehdit edebilen bir komplikasyondur. Red neck sendromu gelişen hastalarda zorunlu
hallerde kortikosterod ve antihistaminiklerle birlikte vankomisin tedavisine
devam edilebilir veya alternatif bir antibiyotik tedavisine geçilebilir. Bu
yazıda, penisiline dirençli pnömokok menenjiti tanısıyla vankomisin tedavisi
başlanan ve tedavinin 8. gününde red neck sendromu gelişen 54 yaşında bir kadın
hasta sunuldu. Hastanın o sabah verilen vankomisin infüzyonunun bir saatten kısa
sürdüğü öğrenildi.  Hastanın vankomisin
tedavisi kesilerek intravenöz linezolid tedavisine geçildi.

Sonuç olarak, vankomisinin hızlı infüzyonuna bağlı olarak red neck
sendromu gelişebilir ve bu olgularda tedavi yönetiminde alternatif ilaç olarak
linezolid kullanılabilir. 

Keywords

Penisiline dirençli pnömokok, menenjit, vankomisin, yan etki, red neck sendromu, , tedavi yönetimi

References

• 1. Ulusoy S. Dirençli pnömokok infeksiyonlarında antimikrobiyal ilaç seçimi. Flora 2003; 8: 22-6.
• 2. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; 20thInformational Supplement, 2010, M100-S20. CLSI, Wayne, PA.
• 3. Edward N. Janoff and Daniel M. Musher. Streptococcus pneumoniae. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 8th Edition, 2015; 201: 2310-27.e5.
• 4. Tunkel AR, Hartman BJ, Kaplan SL, et al. Practice Guidelines for the Management of Bacterial Meningitis. Clinical Infectious Diseases 2004; 39: 1267-84.
• 5. Martel TJ, Whitten RA. Red Man Syndrome. Treasure Island (FL): Stat Pearls Publishing; 2018-.www.ncbi.nlm.nih.gov/pubmed/29494112.
• 6. Sivagnanam S and Deleu D. Red man syndrome. Crit Care 2003; 7: 119-20.
• 7. Polk RE, Healy DP, Schwartz LB, Rock DT, Garson ML, Roller K. Vancomycin and the red-man syndrome: pharmacodynamics of histamine release. J Infect Dis 1988; 157: 502-7.
• 8. Cheung RP, DiPiro JT. Vancomycin: an update. Pharmacotherapy 1986; 6: 153-69.
• 9. Levy M, Koren G, Dupuis L, Read SE. Vancomycin-induced red man syndrome. Pediatrics 1990; 86: 572-80.
• 10. Atalan N, Fazlıoğulları O, Akgün S. Kırmızı adam (red man) sendromu. GKDA Derg 2013; 19: 106-8.
• 11. Polk RE. Anaphylactoid reactions to glycopeptide antibiotics. J Antimicrob Chemother 1991; 27 Suppl B: 17-29.
• 12. Lin SK, Mulieri KM, Ishmael FT. Characterization of vancomycin reactions and inezolid utilization in the pediatric population. J Allergy Clin Immunol Pract 2017; 5: 750-6.