Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
10.22038/abjs.2024.79046.3626
Abstract
Periprosthetic joint infection (PJI) is a critical complication following arthroplasties, often treated with two-stage revision using antibiotic-loaded bone cement spacers. Although these spacers can effectively manage infections, they occasionally cause severe adverse reactions. We report the case of a 68-year-old female who developed vancomycin flushing syndrome (VFS), previously known as red man syndrome, following the insertion of a vancomycin-loaded bone cement spacer during first-stage revision surgery for PJI after undergoing total knee arthroplasty. Six hours postoperatively, she developed pruritus, diffuse rash, tachycardia, and hypotension. VFS was diagnosed based on clinical presentation after excluding other potential causes. She was treated with intravenous epinephrine, antihistamines, steroids, and fluid resuscitation without requiring spacer removal. The patient recovered uneventfully, underwent second-stage reimplantation after six weeks, and remained asymptomatic at 2-year follow-up. This highlights the importance of anticipating and managing this potentially severe reaction through a multidisciplinary approach, considering the risks and benefits of retaining versus removing antibiotic-loaded bone-cement spacers.
Motififard, M., Teimouri, M., Akbari Aghdam, H., Ravanbod, H., & Shahsavan, M. (2024). Challenges in Managing Vancomycin Flushing Syndrome Following Vancomycin-Loaded Bone Cement for Periprosthetic Joint Infection: A Case Report. The Archives of Bone and Joint Surgery, (), -. doi: 10.22038/abjs.2024.79046.3626
MLA
Mehdi Motififard; Mehdi Teimouri; Hossein Akbari Aghdam; Hadi Ravanbod; Mohammad Shahsavan. "Challenges in Managing Vancomycin Flushing Syndrome Following Vancomycin-Loaded Bone Cement for Periprosthetic Joint Infection: A Case Report". The Archives of Bone and Joint Surgery, , , 2024, -. doi: 10.22038/abjs.2024.79046.3626
HARVARD
Motififard, M., Teimouri, M., Akbari Aghdam, H., Ravanbod, H., Shahsavan, M. (2024). 'Challenges in Managing Vancomycin Flushing Syndrome Following Vancomycin-Loaded Bone Cement for Periprosthetic Joint Infection: A Case Report', The Archives of Bone and Joint Surgery, (), pp. -. doi: 10.22038/abjs.2024.79046.3626
VANCOUVER
Motififard, M., Teimouri, M., Akbari Aghdam, H., Ravanbod, H., Shahsavan, M. Challenges in Managing Vancomycin Flushing Syndrome Following Vancomycin-Loaded Bone Cement for Periprosthetic Joint Infection: A Case Report. The Archives of Bone and Joint Surgery, 2024; (): -. doi: 10.22038/abjs.2024.79046.3626
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