A 42-year-old woman is hospitalized due to fever and chills after a hemodialysis session. The patient has a history of end-stage kidney disease due to IgA nephropathy and recently began intermittent dialysis through a tunneled catheter. Medical history includes depression, for which she takes citalopram. Temperature is 38.4 C (101.1 F), blood pressure is 130/80 mm Hg, and pulse is 94/min. There is no erythema or tenderness at the catheter site, and the remainder of the physical examination shows no abnormalities. Blood cultures are obtained, and empiric vancomycin and ceftazidime are initiated. While receiving the intravenous vancomycin infusion, the patient reports a burning, itching sensation. Vital signs are unchanged, but repeat examination shows an erythematous rash involving the face and neck. She reports no history of drug allergy but has never received these antibiotics. Which of the following is the most likely underlying cause of this patient's current condition?

Question

A 42-year-old woman is hospitalized due to fever and chills after a hemodialysis session.  The patient has a history of end-stage kidney disease due to IgA nephropathy and recently began intermittent dialysis through a tunneled catheter.  Medical history includes depression, for which she takes citalopram.  Temperature is 38.4 C (101.1 F), blood pressure is 130/80 mm Hg, and pulse is 94/min.  There is no erythema or tenderness at the catheter site, and the remainder of the physical examination shows no abnormalities.  Blood cultures are obtained, and empiric vancomycin and ceftazidime are initiated.  While receiving the intravenous vancomycin infusion, the patient reports a burning, itching sensation.  Vital signs are unchanged, but repeat examination shows an erythematous rash involving the face and neck.  She reports no history of drug allergy but has never received these antibiotics.  Which of the following is the most likely underlying cause of this patient's current condition?

Quizplus · Accepted Answer

The Answer is C

A 42-Year-Old Woman Is Hospitalized Due to Fever and Chills