What are the other Names for this Condition? (Also known as/Synonyms)

• Red Neck Syndrome

What is Red Man Syndrome? (Definition/Background Information)

• Red Man Syndrome is described as an adverse reaction of the body to vancomycin infusion (often a rapid intravenous administration of vancomycin, which is an antibiotic that is used to treat severe bacterial infections)
• The condition causes intense red rashes, particularly on the face and neck of the affected individuals. Red Man Syndrome may also present other signs and symptoms such as burning sensation, low blood pressure, and dizziness
• Stopping the use of the medication can decrease progression and result in resolution of the condition. The prognosis of Red Man Syndrome is good in a vast majority of cases with prompt recognition of the condition

Who gets Red Man Syndrome? (Age and Sex Distribution)

• According to medical literature, anywhere between 5% to 50% of the individuals (children and adults) treated with vancomycin may develop Red Man Syndrome
• Both males and females are affected
• Individuals of all racial and ethnic background may be affected. Worldwide, no geographical localization has been reported

What are the Risk Factors for Red Man Syndrome? (Predisposing Factors)

• The common risk factor for Red Man Syndrome is the use of vancomycin (to treat certain health conditions) that results in the skin condition as a side effect. In some individuals, vancomycin is used as an alternative to other antibiotics, such as penicillin (PCN), in PCN-allergic patients
• However, there are other drugs that may occasionally cause the condition such as:
  • Amphotericin B injection
  • Cefepime
  • Ciprofloxacin
  • Rifampicin
• Teicoplanin
• Medications that stimulate histamine release can also lead to Red Man Syndrome

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Red Man Syndrome? (Etiology)

• Red Man Syndrome develops from the intravenous administration of vancomycin antibiotic for infections; the condition is known to develop with a rapid infusion of the antibiotic
• The condition may be noted with other antibiotic medications too, such as Cefepime, Ciprofloxacin, and Rifampicin

According to medical research, the overstimulation of mast cells leading to an inflammatory and allergic response, causes Red Man Syndrome. Once activated, mast cells release certain chemicals, such as histamine, that stimulate the body’s inflammatory response, presenting a set of associated signs and symptoms.

What are the Signs and Symptoms of Red Man Syndrome?

The signs and symptoms of Red Man Syndrome may vary from one individual to another. It may also be mild or severe and is related to the usage (dose) of the drug. It is observed that the faster the infusion of the medicine, the more likely is the appearance of red rashes and other symptoms. Skin rashes on the face, neck, and body may be noted within 10-30 minutes of intravenous administration of vancomycin.

Other signs and symptoms that may be seen include:

• Headache
• Lightheadedness
• Itching and burning sensations
• Low blood pressure (hypotension)
• Shortness of breath
• Discomfort
• Fever and chills
• Chest pain

In many individuals, the signs and symptoms are mild and may remain imperceptible.

How is Red Man Syndrome Diagnosed?

A diagnosis of Red Man Syndrome may involve the following tests and exams:

• Complete physical examination with comprehensive evaluation of medical history (which includes the use of vancomycin or other drugs)
• Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Radiological imaging studies and skin biopsy, if necessary

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Red Man Syndrome?

• No specific complications of Red Man Syndrome are generally noted
• However, if individuals are also treated with other medications, including certain painkillers, muscle relaxants, and antibiotics, the condition can become exacerbated due to more severe allergic responses

How is Red Man Syndrome Treated?

• An immediate (and often temporary) discontinuation of vancomycin that is responsible for the side effect may result in improvement and resolution of Red Man Syndrome, often within 20 minutes to a few hours
• The healthcare provider may administer antihistamine medication to treat mild symptoms. However, if shortness of breath and low blood pressure is observed, then additional treatments, such as the use of corticosteroids and IV fluids, may be necessary

It is important to note that the causative medication (vancomycin) is not permanently discontinued but only its dosage and rate of infusion adjusted suitably to prevent recurrence of Red Man Syndrome.

How can Red Man Syndrome be Prevented?

• Currently, there are no known methods available to prevent the occurrence of Red Man Syndrome
• However, the risk may be significantly reduced by slowing down vancomycin infusion rate and/or reducing the dosages

What is the Prognosis of Red Man Syndrome? (Outcomes/Resolutions)

• The prognosis of Red Man Syndrome is generally excellent, since the condition resolves following stoppage of the offending medication
• However, the condition can recur at a later time with usage (rapid infusion) of the same medication (vancomycin). Thus, individuals who are aware of their adverse reaction to the drug have to inform their healthcare providers in prior

Additional and Relevant Useful Information for Red Man Syndrome:

Please visit our Skin Care Health Center for more physician-approved health information:

https://www.dovemed.com/healthy-living/skin-disorders/