Red Man Syndrome……or not?

When Sam had his open heart surgery he got vancomyocin for his peri-operative antibiotic.  When you have surgery you always get an antibiotic ward off any surgical infection. There are 2 they usually pick from. One is ancef which is in a family that is closely related to penicillins (which Sam is highly allergic to) and can lead to cross reactions. For this reason the surgeon picked to use vancomyocin. No chance of reaction….or so he thought!Sam got the first dose during surgery. The second dose was given 8 hours later in the PICU and about 1/2 way thru he looked like this:

Sam’s vanco reaction

They called it not an allergic reaction but an adverse reaction called Red Man Syndrome (RMS) which can happen with vanco. But I had a patient with that once and Sam looked nothing like that patient. If you look at the pic his eyes and lips are swollen. He got better with benadryl. If it is RMS then they can give it again just with benadryl before the dose and then run it slower. So, they did 8 hours later and he this time just got 6-8 hives on his face.
 
I showed the pic yesterday to Sam’s GI and she agreed with me that it was an allergic reaction! I told her I was considering taking him to a pediatric allergist (appt on Dec 17) and talking it all over with him. She agreed that was a great idea! So, I guess that’s the next step for my little antibiotic allergic one. Uggh! Does it ever end!!!!!
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About Tracey

I'm a 35 year old working mamma to 3 wonderful kiddos all with chronic health issues. View all posts by Tracey

4 responses to “Red Man Syndrome……or not?

  • kirst

    Wow Im so sorry with all been going on I missed your posts. Im such a slacker lately. Im glad your wee man has made it through.
    Im allergic to vancomycin also and came out in excruciating stomach pain, itching and burning head,my sinuses all blocked up and a generalised rash over my body a nurse noiced. Then I was at the pass out stage, I was in emergency room at the time when they gave it and they used adrenalin stat and took me to rescus, but because the adrenalin sent my B.P thru the roof the allergy doc (whom I never met) said oh its just redmans because my B.P didn’t bottom out.
    The E.R staff had acted so promptly that it never got a chance to bottom, but whatever they dont give me vancomycin now.
    Im so glad your kids have a great mum like you who looks out for and advocates for her kids 🙂

    • Tracey

      No biggie Kirst!! I’ve been a slacker on keeping it updated too! Yeah he had a real issue with the Vanco! But that’s it so I cannot complain too much. Just a wee problem when you are talking open heart!!

      But I’m just afraid of what future antibiotics will hold for him hence the allergist appt. We’ll see what he has to say then go from there I guess.

  • Jo

    I have the same issues with Vanco. I also had one of the best Infectious Disease docs in the U.S., who said I don’t have RS. And, it’s not an allergic reaction. I get the red spots on several different parts of my body, including my lips and one in the back of my throat. Since Vanco is one of only two antibiotics I CAN take, I always get 50 mg of Benadryl before AND after each dose. The craziest thing about my reactions are that the spots come back at the same place every time!! And, the spots have become permanent. (They look like big freckled spots.)
    Hopefully Sam won’t need to take it again!
    Take care of ALL of your family! ; ) JO

    • Tracey

      Thanks Jo!! Not sure if I ever updated on this but Sam is NOT allergic to Pennicillin. After this reaction to Vanco I had him allergy tested for PCN and he came up negative. The only reason he had Vanco with his open heart was due to the PCN allergy. So, like you said, hopefully he will never need Vanco again!! And also his allergist said it was definately NOT RMS and that it was an allergic reaction but that he could receive it again if needed & if so he would come up with a protocol for him.

      Thanks for your info though. It helps greatly to know there are others out there having similar issues!!

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