The Many Faces of Purpura: Vancomycin-Induced Leukocytoclastic Vasculitis
Leukocytoclastic vasculitis is a rare form of immune-mediated vasculitis that might be caused by infections or autoimmune diseases or might be precipitated by specific medications. We describe a 65-year-old patient, who was receiving vancomycin for a methicillin-sensitive Staphylococcus aureus perma...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Case Reports in Infectious Diseases |
| Online Access: | http://dx.doi.org/10.1155/2021/9932425 |
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| author | John A. Zadroga Vanajakshi Mogulla Christopher Grant Djordje Jevtic Andrew Virata Igor Dumic |
| author_facet | John A. Zadroga Vanajakshi Mogulla Christopher Grant Djordje Jevtic Andrew Virata Igor Dumic |
| author_sort | John A. Zadroga |
| collection | DOAJ |
| description | Leukocytoclastic vasculitis is a rare form of immune-mediated vasculitis that might be caused by infections or autoimmune diseases or might be precipitated by specific medications. We describe a 65-year-old patient, who was receiving vancomycin for a methicillin-sensitive Staphylococcus aureus permacath infection. Vancomycin was chosen due to medication non-adherence and the patient’s desire to receive antimicrobial therapy in conjunction with his scheduled dialysis sessions. The patient’s medical history was notable for untreated hepatitis C infection and end-stage renal disease, requiring hemodialysis three times a week. Vancomycin was administered during dialysis sessions. After one week of therapy, the patient developed bilateral lower extremity purpura. Skin biopsy was suggestive of leukocytoclastic vasculitis with an absence of intravascular thrombi. Serum cryoglobulins were negative, making cryoglobulinemia due to HCV infection unlikely. Following cessation of vancomycin therapy, the rash gradually disappeared with scarring in the form of post-purpuric hyperpigmentation. Despite its widespread use, vancomycin is a rare cause of leukocytoclastic vasculitis. Clinicians should keep in mind a wide range of differential diagnosis of bilateral lower extremity purpura as treatment differs depending on its underlying etiology. |
| format | Article |
| id | doaj-art-00c7d44397f6402fb117a50718249dc0 |
| institution | DOAJ |
| issn | 2090-6625 2090-6633 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Infectious Diseases |
| spelling | doaj-art-00c7d44397f6402fb117a50718249dc02025-08-20T03:22:30ZengWileyCase Reports in Infectious Diseases2090-66252090-66332021-01-01202110.1155/2021/99324259932425The Many Faces of Purpura: Vancomycin-Induced Leukocytoclastic VasculitisJohn A. Zadroga0Vanajakshi Mogulla1Christopher Grant2Djordje Jevtic3Andrew Virata4Igor Dumic5Family Medicine Residency Program, Mayo Clinic Health System, Eau Claire, WI, USADivision of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI, USAMedical College of Wisconsin, Milwaukee, WI, USAUniversity of Belgrade, School of Medicine, Belgrade, SerbiaDivision of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI, USADivision of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI, USALeukocytoclastic vasculitis is a rare form of immune-mediated vasculitis that might be caused by infections or autoimmune diseases or might be precipitated by specific medications. We describe a 65-year-old patient, who was receiving vancomycin for a methicillin-sensitive Staphylococcus aureus permacath infection. Vancomycin was chosen due to medication non-adherence and the patient’s desire to receive antimicrobial therapy in conjunction with his scheduled dialysis sessions. The patient’s medical history was notable for untreated hepatitis C infection and end-stage renal disease, requiring hemodialysis three times a week. Vancomycin was administered during dialysis sessions. After one week of therapy, the patient developed bilateral lower extremity purpura. Skin biopsy was suggestive of leukocytoclastic vasculitis with an absence of intravascular thrombi. Serum cryoglobulins were negative, making cryoglobulinemia due to HCV infection unlikely. Following cessation of vancomycin therapy, the rash gradually disappeared with scarring in the form of post-purpuric hyperpigmentation. Despite its widespread use, vancomycin is a rare cause of leukocytoclastic vasculitis. Clinicians should keep in mind a wide range of differential diagnosis of bilateral lower extremity purpura as treatment differs depending on its underlying etiology.http://dx.doi.org/10.1155/2021/9932425 |
| spellingShingle | John A. Zadroga Vanajakshi Mogulla Christopher Grant Djordje Jevtic Andrew Virata Igor Dumic The Many Faces of Purpura: Vancomycin-Induced Leukocytoclastic Vasculitis Case Reports in Infectious Diseases |
| title | The Many Faces of Purpura: Vancomycin-Induced Leukocytoclastic Vasculitis |
| title_full | The Many Faces of Purpura: Vancomycin-Induced Leukocytoclastic Vasculitis |
| title_fullStr | The Many Faces of Purpura: Vancomycin-Induced Leukocytoclastic Vasculitis |
| title_full_unstemmed | The Many Faces of Purpura: Vancomycin-Induced Leukocytoclastic Vasculitis |
| title_short | The Many Faces of Purpura: Vancomycin-Induced Leukocytoclastic Vasculitis |
| title_sort | many faces of purpura vancomycin induced leukocytoclastic vasculitis |
| url | http://dx.doi.org/10.1155/2021/9932425 |
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