HD is a 52-year-old white male, who had surgery on his right
foot following a crush injury sustained in a car accident. The
surgical wound developed signs of infection and a culture of the
wound was taken during surgical debridement but was negative for
growth. HD was placed on Vancomycin along with Ceftriaxone, and
ciprofloxacin. 19 days later HD developed a rash over most of his
body and a fever. Blood tests indicated a high eosinophil count and
elevated aspartate aminotransferase (AST) and alanine
aminotransferase (ALT) at twice the normal levels. A subsequent
genetic test revealed HD had the HLA-A*32:01 haplotype.
What is the reaction to vancomycin experienced by HD called?
What would you suggest be done about HD’s reaction to
vancomycin?
- Hd Is A 52 Year Old White Male Who Had Surgery On His Right Foot Following A Crush Injury Sustained In A Car Accident 1 (192.4 KiB) Viewed 30 times
FOR CLINICAL USE Test Details Gene Genotype Phenotype Alleles Tested CYP2C19 *1/01 *2/2 Normal Metabolizer Normal Metabolizer CYP2D6 *2, +3, +4,*4B,*5, 6, 7, 8, 9, *17 *2,3,*4, *4M, *6,*7, 48, 49,*10,*12, *14A,*14B, 17,29,35,41 CYP3A5 CYP3A4 *3/3 *1/1B - 1639G > AG/G *1/01 *1D, 2, 3, 3B,*3C, *6,7,8,9 *1B, *2, 13, *12*17,*22 -1639G>A *2, 3, 4, 5, 6, *11 VKORC1 Poor Metabolizer Normal Metabolizer Low Warfarin Sensitivity Normal Metabolizer Normal Metabolizer Normalfunction Negative CYP2C9 CYP2B6 *6,9 SLCO101 521T>C388A>G *1/1 521T>CT/T rs 75527207 G/G *1/*1 CFTR Numerous DPYD Normal Metabolizer Numerous *2, *3A, *3B, *3C4 TPMT Poor Metabolizer Normal G6PD HLA-B*15:02 Numerous All HLAB 15 HLA-B*57:01 *2/3 Bor B/B negative/negative negative positive negative negative negative negative positive/ negative All HLAB*57 HLA-B*58:01 Negative Positive Negative Negative Positive All HLAB*58 HLA-A31:01 All HLAA*31 HLA-A*32:01 All HLAA*32 Cancer Biopsy, cfDNA & IHC Test Details: Cancer Gene Gene Status Phenotype BRAF Wild type wt) wt BCR-ABL Not detected id) wt EGFR wt wt KRAS Wt wt MGMT Methylated promoter Unmethylated promotewt gene Not done MGMT-negative BRCA1-positive BRCA1 ER PR Not done HER2 Not detected absent