Synonym(s)
Red-child syndrome; Red man syndrome; Red-neck syndrome; vancomycin-induced exanthema
DefinitionThis section has been translated automatically.
After rapid intravenous injection of vancomycin and other drugs, non-allergic, flush-like exanthema with drop in blood pressure. Common side effect. Also described in children with an overdose of rifampicin (Red-child syndrome).
EtiopathogenesisThis section has been translated automatically.
Vancomycin or other drugs (e.g. ampicillin and Infliximab)-induced histamine release with consecutive vascular dilatation is being discussed. The severity of the symptoms depends on the amount and especially the infusion rate of the administered vancomycin.
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LocalizationThis section has been translated automatically.
Head, neck, upper body
Clinical featuresThis section has been translated automatically.
During or shortly after completion of the vancomycin infusion, macular or urticarial exanthema, possibly angioedema, which begins on the head and slowly spreads to the upper half of the body. Severe itching. Sudden sharp drop in blood pressure up to circulatory collapse. Recovery after a few hours.
General therapyThis section has been translated automatically.
If possible, discontinue the triggering agent.
Internal therapyThis section has been translated automatically.
Antihistamines such as clemastine (e.g. Tavegil) or dimetinden (e.g. Fenistil) 2 times/day 1 amp. i.v., for severe reactions glucocorticoids such as prednisolone Solu-Decortin H i.v. Sufficient fluid intake.
ProphylaxisThis section has been translated automatically.
Distribution of the vancomycin dose over several infusions daily, slow infusion rate, prior administration of an H1 antagonist such as clemastine (e.g. Tavegil injection solution) 2 times/day 1 amp. i.v. or Dimetinden (e.g. Fenistil) 1-2 times/day 1 amp. i.v.
LiteratureThis section has been translated automatically.
- Bolan G, Laurie RE, Broome CV (1986) Red man syndrome: inadvertent administration of an excessive dose of rifampicin to children in a daycare center. Pediatrics 77: 633-635
- Garrelts JC et al (1990) Vancomycin and the red man's syndrome. N Engl J Med 312: 245
- Hassaballa H et al (2000) Vancomycin anaphylaxis in a patient with vancomycin-induced red man syndrome. At J Ther 7: 319-320
- Healy DP et al (1990) Vancomycin Induced Histamine Release and Red Man Syndrome: Comparison of 1- and 2-Hour Infusions. Antimicrob Agents Chemother 34: 550-554
- Lobel EZ et al (2003) Red man syndrome and infliximab. J Clin Gastroenterol 36: 186
- Newton RW, Forrest AR (1975) Rifampicin overdosage - The red man syndrome. Scott Med J 20: 55-56
- Salazar de Sousa J et al (1987) Red child syndrome. Arch Dis Child 62: 1181
- Sivagnanam S et al (2003) Red man syndrome. Crit Care 7: 119-120
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Outgoing links (13)
Ampicillin; Angioedema (overview); Antihistamines, systemic; Clemastine; Dimetinden; Glucocorticosteroids; Infliximab; Prednisolone; Pruritus; Rash; ... Show allDisclaimer
Please ask your physician for a reliable diagnosis. This website is only meant as a reference.
Prof. Dr. med. Peter Altmeyer