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han secondary headache. Sodium valproate was the commonly used prophylaxis in migraine.We report a case of a 57-year-old male with a past medical history of controlled hypertension and type 2 diabetes mellitus, who had unusual elevated serum concentration levels of vancomycin during oral treatment for Clostridium difficile pseudomembranous colitis. Both measured serum vancomycin levels of 39 μg/ml and cerebrospinal fluid level of 5.7 μg/mL were documented and associated with unexplained neurological symptoms and sexual dysfunction. After