Red Man Syndrome

What is Red Man Syndrome?

This is a response to the medication vancomycin. Individuals classically cultivate symptoms within five (5) or ten (10) minutes of getting the medication and they develop flushing and itching of the neck, torso and face. Individuals might also develop face swelling as well as swelling of the eyes or lips and/or a blood pressure drop, but this is much less common. This syndrome is not a real allergy, even though symptoms look comparable to an allergy response.

It is also referred to as RMS.


Red Man Syndrome is characterized by:

  • Flushing
  • Erythema
  • Pruritus
  • Affects body, neck and face
  • Pains
  • Muscle spasms
  • Dyspnea
  • Hypotension
  • Fever and chills
  • Swollen lymph nodes
  • Increased heart rate
  • Swelling of the eyelid leading to ectropion
  • Dehydration
  • Secondary infections

RMS is seldom life-threatening, but severe toxicity cardiovascular and in some situation can cause cardiac arrest. IgE-mediated anaphylaxis may show symptoms identical or similar to those of severe RMS, necessitating that physicians be aware of this substitute diagnosis.

Apart from reddening of the skin, RMS causes other symptoms also. These comprise peeling and thickening of skin, which begins within six (6) days from the beginning of symptoms. The skin can peel off in large sheets or small flakes. If left not treated, such skin can start serous ooze that can be smelly and sticky. Severe or moderate itching is also one of the RMS symptoms. Skin thickening is found to be more prominent in the soles and palms. Even the scalp cultivates resultant hair loss and scaling. In some cases, nails will develop ridges and may also shed.

Symptoms need to be prevented or treated with antihistamines, including diphenhydramine and are must less likely to happen with infusion that is slow.


RMS is established to happen in individual with other causal medical conditions, such as, lung cancer, HIV infection, fallopian tubes, colon, and rectum, Graft vs. Host disease, etc. It has also been perceived that this condition can transpire without any obvious cause. Studies have shown that approximately 30% of RMS cases are without any cause. While this condition is termed as exfoliative dermatitis, erythroderma or, it is said that some medical experts only use the name RMS, for idiopathic erythroderma only.


This syndrome is treated usually based on the underlying cause. So, proper diagnosis is extremely important in treating this disorder. In cases of symptoms that are severe, hospitalization is needed for management of the situation of the individual. Generally, management for this syndrome involves the maintenance of the moisture of the skin with wet dressing, wet wraps, emollients, etc. The temperature of the body, balance of the electrolytes, etc. has to be regularly monitored. While, unneeded medications are stopped, the individual may be directed with mild topical steroids, antihistamines (for itching) antibiotics (for secondary infection), etc. In cases where the cause underlying is detected, management will be mostly directed at treating that disorder (apart from management of the symptoms).

If vancomycin is still needed for the underlying condition, it must be managed in a dilute solution gradually, over approximately 60 minutes (max rate of 10 mg/minute for doses less than 500 mg). This is caused by the high occurrence of thrombophlebitis and pain and to evade an infusion response known as RMS or Red Neck syndrome. If symptoms develop they need to be prevented or treated with antihistamines, such as diphenhydramine and are less expected to occur with slow infusion.


Red Man Syndrome Pictures

Red man Syndrome Picture 1


Red man Syndrome Picture 2

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Red man Syndrome Photos

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Red man Syndrome Images

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