SHM Converge Scientific Abstract ePoster Gallery-Rare Manifestation of Clindamycin Induced Leukocytoclastic Vasculitis in a Patient With Multisystem Involvement: A Case Report and Review of Diagnostic Challenges

Rare Manifestation of Clindamycin Induced Leukocytoclastic Vasculitis in a Patient With Multisystem Involvement: A Case Report and Review of Diagnostic Challenges

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This case describes a 60-year-old man who developed progressive palpable purpura/rash, abdominal discomfort, and diarrhea shortly after starting clindamycin for cellulitis. The rash began on both lower extremities and later spread to the back and face. Laboratory studies showed elevated ESR and CRP, increased C3, and mildly elevated AST/ALT with a negative hepatitis panel. Skin biopsy revealed folliculitis with a small focus of leukocytoclastic vasculitis (LCV). Autoimmune testing was initially positive for ANA, low-titer anti-dsDNA, and antimitochondrial antibody, but these antibodies became negative on repeat testing, supporting a drug-related process rather than a chronic autoimmune disease.<br /><br />The patient was treated with high-dose corticosteroids and discharged with rheumatology follow-up. The authors concluded that the presentation was most consistent with clindamycin-induced LCV, a rare adverse reaction. Drug-induced vasculitis accounts for about 10% of vasculitis cases and typically appears 1–3 weeks after starting the offending medication. Antibiotics are common triggers, but clindamycin is an unusual cause, with very few reported cases over the past several decades.<br /><br />The report emphasizes that LCV can be underdiagnosed when it appears in atypical locations such as the torso rather than only the lower extremities. It also highlights the importance of biopsy for confirming severity and diagnosis. Because clindamycin is frequently used in inpatient care, clinicians should recognize this potential complication. The authors further note that limited dermatology access in rural hospitals makes teledermatology and interdisciplinary care important for timely diagnosis and management of cutaneous vasculitis.

Asset Subtitle

Graciela M. Luna

Meta Tag

Author List Anas Bizanti, Domenica Del Pozo, Graciela M. Luna, Melanie Duran

Category Clinical Vignettes

Concept Leukocytoclastic Vasculitis

Concept Palpable Purpura

Concept Skin Biopsy

Concept Clindamycin

Concept Discontinuation

Distinguished Non-Finalist

Presenter Organization Lakeland Regional Health Medical Center

Presenting Author Graciela M. Luna

Track Adult

Keywords

clindamycin-induced leukocytoclastic vasculitis

palpable purpura

drug-induced vasculitis

cellulitis

skin biopsy

corticosteroid treatment

abdominal discomfort

diarrhea

teledermatology

cutaneous vasculitis

Leukocytoclastic Vasculitis

Palpable Purpura

Skin Biopsy

Clindamycin

Discontinuation