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Red man syndrome with teicoplanin.

SIR-The "red-man" syndrome (RMS), an adverse effect often observed in patients who receive therapy with vancomycin, is mediated by histamine release [1, 2]. Teicoplanin appears to be an alternative for treatment of severe infections caused by gram-positive bacteria in patients who develop RMS as a result of the use of vancomycin [3]. There have been two anecdotal reports of RMS associated with the use of teicoplanin [3]. We report a case of RMS in a patient who was receiving therapy with teicoplanin. A 59-year-old man was admitted to H6pital la Croix-Rousse in Lyon, France, for a syncopal episode that was related to hypersensitivity of the carotid sinus. The patient had a history of chronic obstructive pulmonary disease, and he had no known allergies. The patient was found to have osteitis of the elbow that was caused by methicillin-resistant Staphylococcus aureus. Cultures of blood remained sterile.