• Stanislas Bataille, Aurélie Daumas, Anne-Marie Tasei, Noémie Jourde-Chiche, Bertrand Dussol, Stéphane Burtey, Solène Taugourdeau, Yvon Berland, and Laurent Chiche.
• Centre de Néphrologie et Transplantation rénale, Hôpital de la Conception, Assistance Publique des Hôpitaux de Marseille, 147 Boulevard Baille, 13005 Marseille, Université Aix-Marseille II, France. stanislas.bataille@ap-hm.fr.
• J Med Case Rep. 2012 Jan 1;6:106.

IntroductionHenoch-Schönlein purpura is a small-vessel systemic vasculitis. Although its exact pathophysiology remains unknown, Henoch-Schönlein purpura has been reported in association with various medical conditions including hypersensitivity. We report the case of a patient with vancomycin-induced Henoch-Schönlein purpura.Case PresentationA 42-year-old Caucasian man who had previously undergone a heart transplant was diagnosed as having an intra-abdominal abscess after he underwent a Hartmann procedure. At 15 days after initiation of antibiotic therapy including vancomycin, he developed a purpuric rash of the lower limbs, arthralgia, and macroscopic hematuria. At that time, our patient was already on hemodialysis for end-stage renal disease. Henoch-Schönlein purpura was diagnosed. After a second 15-day course of vancomycin, a second flare of Henoch-Schönlein purpura occurred. Skin biopsies showed leucocytoclastic vasculitis with IgA deposits and eosinophils in the peri-capillary inflammatory infiltrate, suggesting an allergic mechanism. After vancomycin was stopped, we did not observe any further flares. Only five cases of isolated cutaneous vasculitis, one case of lupus-like syndrome and one case of Henoch-Schönlein purpura after vancomycin treatment have been described to date in the literature.ConclusionsClinicians should be aware that systemic vasculitis can be induced by some treatments. Vancomycin is a widely prescribed antibiotic. Occurrence of rare but serious Henoch-Schönlein purpura associated with vancomycin requires its prompt discontinuation.

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