Kýrmýzý Adam (Red Man) Sendromu

Vankomisin; MRSA baþta olmak üzere Gram (+) bakteri infeksiyonlarýnda sýklýkla kullanýlan bir antibiyotiktir. Bu olgu sunumunda açýk kalp cerrahisi ameliyatý sonrasýnda mediastinit infeksiyonu nedeniyle uygulanan vankomisin tedavisi sýrasýnda görülen Red Man Sendromunun (RMS) tartýþýlmasý amaçlandý.
Elli altý yaþýndaki erkek hastada koroner arter baypas (KABG) ameliyatý sonrasýnda geliþen metisiline dirençli Stafilacoccus aureus (MRSA) mediastiniti nedeniyle vankomisin 2x1 gr IV baþlandý. Hastanýn tedavisinin 5. gününde özellikle vücudun üst kýsmýnda daha fazla olmak üzere tüm gövdede yaygýn, yer yer birbiriyle birleþen, kaþýntýlý kýzarýklýklar, eritematöz döküntüler ve hipotansiyon geliþti. Dermatoloji ile konsülte edilen hastaya RMS tanýsý kondu. Genellikle hýzlý vankomisin infüzyonuna baðlý olarak ortaya çýkan RMS’da Teikoplanin ve Linezolid alternatif tedavi seçenekleri olarak düþünülebilir.

Red Man Syndrome

Vancomycin is one of the glycopeptide antibiotics which is used against Gram (+) bacterial infections especially caused by Methicillin Resistant Staphylococcus Aureus (MRSA). In this case report, we want to present a patient in whom “Red Man Syndrome” (RMS) was developed due to vancomycin treatment for the mediastinitis following coronary arterial bypass surgery (CABG).
A 56 year- old patient who had CABG developed MRSA mediastinitis. Based on the results of the antibiotic susceptibility tests, intravenous vancomycin (1g bid) treatment was started. At 5th day of the treatment disseminated and partly intermingled, itchy and erytematous rushes especially at the upper part of the body and hypotension were developed. Following dermatological evaluation, diagnosis of RMS was established. RMS usually happens as a result of rapid infusion of vancomycin. In these circumstances. Teicoplanin and Linezolid should be thought as alternative treatment regimens.