Cefazolin as a cause of leukocytoclastic vasculitis

Abstract

Key Clinical MessageLeukocytoclastic vasculitis (LCV) is a cutaneous small vessel vasculitis characterized by cutaneous manifestations in the form of palpable purpura, and rarely bullae, vesicles, and ulcerations. Although rare, cephalosporins such as cefazolin, should be recognized to have a potential to trigger LCV.

Ceftriaxone-induced leukocytoclastic vasculitis: a case report and literature review of antibiotic-induced leukocytoclastic vasculitis

“…A total of 60 published articles were included, comprising a total of 74 cases published between 1955 and 2021 (Table 1). 20,26,27,30 –86 Analyses of the reported cases of antibiotic-induced leukocytoclastic vasculitis revealed that it is associated with numerous classes of antibiotic, including penicillin (amoxicillin, amoxicillin-clavulanic acid, oxacillin), cephalosporins (cefazolin, cephalexin, cefuroxime, ceftriaxone, cefotaxime), fluoroquinolone (ciprofloxacin, levofloxacin, ofloxacin), macrolides (azithromycin, clarithromycin), vancomycin, teicoplanin, trimethoprim-sulfamethoxazole, dapsone, linezolid, pristinamycin, tigecycline, isoniazid, streptomycin, rifampin, ethambutol, and pyrazinamide.…”

Cephalexin-Induced Leukocytoclastic Vasculitis

“…We used the search terms ‘cephalosporin’, ‘cephalexin’, ‘hypersensitivity vasculitis’, ‘leukocytoclastic vasculitis’, and found a total of three case reports linking a cephalosporin with dermatologic manifestations. One case report implicated ceftriaxone, a second implicated cefazolin, and a third implicated cefuroxime [ 5 , 11 , 12 ].…”

“…Here, we present a case report of leukocytoclastic vasculitis caused by cephalexin, a cephalosporin. Leukocytoclastic vasculitis is a cutaneous small-vessel vasculitis characterized by cutaneous manifestations in the form of palpable purpura, and rarely ulcerations, vesicles, and bullae [ 5 ]. We present a case of a patient that was prescribed cephalexin for a urinary tract infection, and developed hypersensitivity vasculitis, leading to end-stage renal disease necessitating the initiation of hemodialysis.…”

Vasculitis in Cystic Fibrosis

“…In particular, antibiotics such as penicillins and cephalosporins, can cause ICs deposition in blood vessel walls leading to the development of leukocytoclastic vasculitis. This so-called type III hypersensitivity reaction is mediated by the deposition of drug-containing IC that fail to be removed after precipitation (21)(22)(23). Lastly, chronic inflammation results in cell and tissue damage that causes uncontrolled release of intracellular components to the extracellular space.…”