Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 1 3 2015 10 03 99 100 EN Zahid Hussain Khan Department of Anesthesiology and Critical Care, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 03 2015 10 03 This case report describes an unusual spectrum of a proved anaphylactoid reaction to vancomycin during general anesthesia for release of tethered spinal cord in a 14 year old girl. Bronchospasm which is the sine qua non of a classical anaphylactoid reaction was singularly absent in this particular case. Our objective in this presentation is to highlight the importance of early recognition of this potentially fatal drug reaction which should be taken into consideration in the absence of bronchospasm if other clinical signs are subtle and unequivocal. https://aacc.tums.ac.ir/index.php/aacc/article/view/17 https://aacc.tums.ac.ir/index.php/aacc/article/download/17/186