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Stevens-Johnson Syndrome Secondary to Vancomycin Exposure

A case of Stevens-Johnson syndrome (SJS) is reported in a 64- year-old woman following 8 days of vancomycin for the treatment of a urinary tract infection with methicillin-resistant Staphylococcus aureus. Diffuse erythematous plaques with dusky centers confluent over the trunk, arms, and axillae, lesions of the oral mucosa, and conjunctiva involvement were present. Beta-lactam antibiotics, sulfa drugs, and anticonvulsants have the highest incidences of SJS. Cases of vancomycin-induced SJS have been reported in the literature. This patient received supportive care and systemic and topical corticosteroids. However, the efficacy and safety associated with the use of corticosteroids in the treatment of SJS remain controversial. Vancomycin has been associated with the development of SJS and the ability of corticosteroids to decrease morbidity, and slow the progression of lesions associated with SJS remains unclear.