Red man syndrome

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]

Overview

Red man syndrome is characterized by symptoms consistent with anaphylactoid reactions. These symptoms may include dyspnea, hypotension, urticaria, pain and spasm of chest and back muscles, wheezing, pruritus, and upper body flushing giving the typical appearance and thus the name "Red man syndrome”. On discontinuation of the offending agent, these symptoms can resolve as early as 20 minutes but in some cases may require several hours. Vancomycin is the most common agent responsible for Red man syndrome.

Red Man Syndrome

Various features of red man syndrome include:

Causes

Patients in whom vancomycin  infusion is given over less than 1 hour and who are not pre-treated with diphenhydramine |Hypersensitivity to:

• Vancomycin
• Ciprofloxacin
• Amphotericin B
• Rifampicin
• Teicoplanin

Symptoms

Some associated symptoms of red man syndrome include:

• Headache
• Chills
• Diziness
• Chest pain
• Dyspnea
• Pruritis
• Rash
  • Erythematous rash that involves the
  • Face
  • Neck and
  • Upper torso

Differentiating from Anaphylactoid Reaction

Red man syndrome must be differentiated from anaphylactoid reaction.

• Absence of elevation in tryptase levels indicating that it is an anaphylactoid reaction