PEDIATRICS Vol. 77 No. 5 May 1986, pp. 633-635
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Red Man Syndrome: Inadvertent Administration of an Excessive Dose of Rifampin to Children in a Day-Care Center

Gail Bolan MD1, Robert E. Laurie MD, MPH1, and Claire V. Broome MD1

1 From the Division of Bacterial Diseases, Center for Infectious Diseases, Centers for Disease Control, Atlanta, and the Florida Department of Health and Rehabilitative Services, Leon County Public Health Unit, Tallahassee, Florida

A cluster of toxic reactions among children inadvertently given excessive doses of rifampin for chemoprophylaxis of invasive Haemophilus influenzae disease in a day-care center was investigated. In all 19 children, who received five times the therapeutic dose of rifampin, dramatic adverse reactions developed. A striking, "glowing" red discoloration of the skin and facial or periorbital edema were found to be the hallmarks of rifampin toxicity. These clinical signs of acute toxicity contrast sharply with the adverse side effects of rifampin reported with therapeutic doses.

Key Words: rifampin • toxicity • side effects • chemoprophylaxis • Haemophilus influenzae

Submitted on December 12, 1983
Accepted on August 12, 1985




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