Table 2.
Clinical data for cases of Linear IgA bullous dermatosis to vancomycin (LABD, n=34). All patients had characteristic skin biopsy findings and direct immunoflourescence with linear IgA deposition along the basement membrane/dermal-epidermal junction.
| Age (yrs) |
Sex (M/ F) |
Infection treated |
Reactio n timing |
Skin Sloughing |
Mucosal Involvement |
Other rash atypical feature |
Treatment | Outcome | |
|---|---|---|---|---|---|---|---|---|---|
| Kakar et al. 2013 |
91 | F | Acute cholecystitis Sepsis |
2d | 40% BSA | Oral | Vesicles | Comfort measures only |
Deceased, from HSR |
| Selvaraj et al. 2013 |
70 | F | Post- operative sepsis |
5d | Oral | Vesicles Palms affected |
Discontinuation of vancomycin |
Full resolution within 14d |
|
| Jawitz et al. 2011 |
78 | F | HAP post-op | 28d | Topical steroids | Full resolution in 10d |
|||
| O’Brien et al. 2011 |
45 | M |
Clostridium
dificile colitis |
2d | Discontinuation of vancomycin Camphorylated moisturizer |
Full resolution | |||
| McDonal d et al. 2010 |
32 | M | VAP | 10d | Discontinuation of vancomycin |
Full resolution | |||
| Walshe et al. 2009 |
76 | M |
Staphylococ
cus bacteremia |
9d | Oral steroids Discontinuation of vancomycin |
Full resolution | |||
| Khan et al. 2008 |
57 | M | Liver and splenic abscesses Laparotomy |
35d | 75% BSA | Palms and Soles affected |
Topical steroids HD IVIG |
Deceased, from HSR |
|
| Senanaya ke et al. 2008 |
68 | M | Post-op wound infection |
4d | Oral | Palms affected |
Oral steroids Discontinuation of vancomycin |
Full resolution | |
| Billet et al. 2008 |
70 | M | Post-op perihepatic abscess, MRSA, Enterococcu s |
5d | No bullae | Oral steroids Dapsone |
Clinically improved within 3d |
||
| Billet et al. 2008 |
61 | F | Post-op wound abdominal infection |
13d | No bullae | Topical steroids Discontinuation of vancomycin |
Clinically improved in 6d |
||
| Navi et al. 2006 |
73 | M | ICD placement |
3d | Vesicles | Discontinuation of vancomycin |
Full resolution in 2 weeks |
||
| Waldman et al. 2004 |
77 | M | CABG, complicated post-op course |
6d | 46% BSA | Silvadene dressing changes q12h Dapsone |
Complete re- epithelialization within 3 weeks Deceased, from cardiac complications |
||
| Joshi et al. 2004 |
48 | F | TVH c/b pelvic abscess |
10d | Discontinuation of vancomycin |
Full resolution | |||
| Armstron g et al. 2004 |
81 | M | AAA repair c/b wound infection |
3d | Target lesions |
Discontinuation of vancomycin |
Full resolution in 3 weeks |
||
| Dellavalle et al. 2003 |
74 | M | Pneumonia | 4d | 90% BSA | Oral | Discontinuation of vancomycin |
Deceased, from septic shock |
|
| Neughbau er et al. 2002 |
52 | F |
Escherichia
coli urosepsis |
<1d | Vesicles | Discontinuation of vancomycin |
Full resolution in 2 weeks |
||
| Palmer et al. 2001 |
75 | F | Infected varicose ulcer |
6d | Urticaria | Oral steroids Dapsone |
Full resolution | ||
| Palmer et al. 2001 |
86 | F | Fracture of femur s/p repair |
4d | “Diffuse” | Oral steroids | Deceased, from pneumonia and complications of HSR |
||
| Palmer et al. 2001 |
78 | F | CABG c/b MRSA wound infection |
15d | Urticaria | Topical steroids Discontinuation of vancomycin |
Resolution of rash Deceased, from renal failure |
||
| Klein et al. 2000 |
65 | M | Sepsis due to Klebsiella pneumoniae, P.aeruginos a, Staphylococ cus species |
14d | Discontinuation of vancomycin |
Full resolution in 4 weeks |
|||
| Mofid et al. 2000 |
87 | F | Urinary tract infection |
11d | Oral | IV steroids Discontinuation of vancomycin |
Full resolution | ||
| Danielsen et al. 1999 |
68 | M | Culture negative endocarditis |
9d | Vesicles | Topical steroids Discontinuation of vancomycin |
Full resolution within 10d |
||
| Bernstein et al. 1998 |
60 | F | Enterocutan eous fistula |
10d | Oral steroids Discontinuation of vancomycin |
Full resolution | |||
| Nousari et al. 1998 |
65 | F |
P.aeruginos
a S.epidermidi s sepsis |
7d | Discontinuation of vancomycin |
Full resolution within 30 days |
|||
| Whitwort h et al. 1996 |
63 | M | Cardiac catherization |
1d | Oral steroids Discontinuation of vancomycin |
Full resolution within 3 weeks |
|||
| Richard et al. 1995 |
72 | F | Total pelvic ex- enteration for TCC of the bladder |
2d | Oral and genital |
Target lesions Papules |
Discontinuation of vancomycin |
Full resolution of eruptions over 2 weeks |
|
| Geismann et al. 1995 |
79 | M |
S. aureus
cellulitis |
8d | Oral and genital |
Discontinuation of vancomycin |
Full resolution | ||
| Kuechle et al. 1994 |
69 | M | Draining sinus tract status-post CABG |
14d | Discontinuation of vancomycin |
Full resolution within 3 weeks |
|||
| Kuechle et al. 1994 |
74 | F | Sternal wound infection status-post CABG |
5d | Target lesions Palms affected |
Discontinuation of vancomycin |
Full resolution | ||
| Kuechle et al. 1994 |
67 | M | Sternal wound infection status-post CABG |
1d | Vesicles | Discontinuation of vancomycin |
Full resolution | ||
| Carpenter et al. 1992 |
54 | M | Bowel perforation |
10d | Discontinuation of vancomycin |
Full resolution within 9 months |
|||
| Carpenter et al. 1992 |
72 | F | Intra- abdominal abscess |
7d | Palms and soles affected |
Discontinuation of vancomycin |
Full resolution within 2 weeks |
||
| Carpenter et al. |
54 | M | Osteomyeliti s |
21d | Vancomycin continued for an additional 3 weeks without worsening |
Full resolution | |||
| Baden et al. 1988 |
68 | M |
E.coli
urosepsis Post-op (CABG) |
9d | Discontinuation of vancomycin Twice daily compresses Bacitracin |
Resolution within 2 weeks |
* Timing from vancomycin dose to reaction onset
Abbreviations: d: days; BSA: body surface area; HSR: hypersensitivity reaction; HAP: hospital acquired pneumonia; VAP: ventilator associated pneumonia; HD: hemodialysis; IVIG: intravenous immunoglobulins; MRSA: methicillin-resistant Staphylococcus aureus; ICD; implantable cardioverter defibrillator; CABG: coronary artery bypass graft; h: hours; TVH: total vaginal hysterectomy; c/b: complicated by; AAA: abdominal aortic aneurysm; s/p: status-post; IV: intravenous; TCC: transitional cell carcinoma