58歲男性病患，有高血壓與癲癇病史，因二次中風再度入院，住院期間，疑似藥物造成毒性表皮細胞壞死溶解症（TEN），可疑藥品包括：vancomycin、levofloxacin、topiramate、meropenem。在發現可能是藥物造成的TEN後，立即停用全部可疑藥物，並以支持療法維持，經24天後改善出院。經藥師回顧文獻後，認為vancomycin最可疑，但仍無法排除levofloxacin。2個月後，病患再度住院，因病情需要，再度使用vancomycin，2小時之後隨即出現皮膚的不良反應，因此我們更加確定vancomycin引起TEN。

A 58-year-old male patient with a history of epilepsy and hypertension was readmitted to the hospital caused by his second stroke. During the hospitalization it was suspected that he encountered drug- induced Toxic Epidermal Necrolysis (TEN). Possible suspected drugs include vancomycin, levofloxacin, topiramate, and meropenem. The suspected drugs were immediately withdrawn and supporting therapy was given. The patient was released 24 days later after seeing significant improvement. Further review by the pharmacist on many articles about TEN suggested that most likely drug is vancomycin, but we still can not rule out levofloxacin. Two months later, the patient was hospitalized and vancomycin was used as needed by the treatment. Two hours later, his skin show adverse reactions. We further confirmed that vancomycin was the drug that caused TEN.