Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 6, 2021; 9(13): 3070-3078
Published online May 6, 2021. doi: 10.12998/wjcc.v9.i13.3070
Vancomycin-related convulsion in a pediatric patient with neuroblastoma: A case report and review of the literature
Qiao-Feng Ye, Guang-Fei Wang, Yi-Xue Wang, Guo-Ping Lu, Zhi-Ping Li
Qiao-Feng Ye, Guang-Fei Wang, Zhi-Ping Li, Department of Clinical Pharmacy, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai 201102, China
Yi-Xue Wang, Guo-Ping Lu, Department of Pediatric Intensive Care Unit, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai 201102, China
Author contributions: Ye QF and Wang GF visualized the data, reviewed the literature and drafted the manuscript; Wang YX and Lu GP contributed to the treatment of this patient and provided the patient’s medical data; Li ZP reviewed the literature and revised the manuscript; All authors issued final approval for the version to be submitted; Ye QF and Wang GF are co-first authors of this work.
Supported by National Natural Science Foundation of China, No. 81874325; Key Innovative Team of Shanghai Top-Level University Capacity Building in Clinical Pharmacy and Regulatory Science at Shanghai Medical College, Fudan University, No. HJW-R-2019-66-19; Science and Technology Commission of Shanghai Municipality, No. 18DZ1910604, No. 19DZ1910703 and No. 19XD1400900.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying data.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Ping Li, PhD, Chief Pharmacist, Department of Clinical Pharmacy, National Children's Medical Center, Children's Hospital of Fudan University, No. 399 Wanyuan Road, Shanghai 201102, China. zpli@fudan.edu.cn
Received: October 20, 2020
Peer-review started: October 20, 2020
First decision: January 7, 2021
Revised: January 11, 2021
Accepted: February 22, 2021
Article in press: February 22, 2021
Published online: May 6, 2021
Core Tip

Core Tip: Vancomycin is often used as an anti-infective drug in patients receiving anti-tumor chemotherapy. We present a rare case of sudden onset of convulsion related to vancomycin treatment in a pediatric patient with neuroblastoma. This case demonstrates that unexpected convulsion occurring in patients after chemotherapy is probably due to the toxicity caused by abnormal pharmacokinetics of vancomycin. Close therapeutic drug monitoring is recommended to ensure the plasma concentration of vancomycin is within the normal range. A model-based Bayesian estimation tool could be used to estimate the area under the concentration-time curve and help health care practitioners create an individualized dosing plan.