Abstract
Acute eosinophilic pneumonia (AEP) is a rare entity, often resulting in respiratory failure and the attended mortality. Daptomycin-induced AEP results from immune-mediated pulmonary epithelial cell injury. A 65-year-old male on treatment with intravenous daptomycin for three weeks came to the hospital for worsening dyspnea and acute hypoxemic respiratory failure. Computerized tomography (CT) of the chest was done, revealing bilateral pulmonary infiltrates. He underwent bronchoscopy that showed predominant pulmonary eosinophilia. The bacterial, fungal, viral, and mycobacterial cultures were all negative. Daptomycin was discontinued, and the patient was started on steroid therapy. He received a two-week course of steroids with a rapid taper, attaining complete recovery with a near-complete resolution of pulmonary infiltrates. A shorter course of steroid therapy should be sufficient to treat a case, as indicated in our case. Commonly used diagnostic criteria for AEP using more than 25% of pulmonary eosinophilia should be tailored to patient-related factors.
Highlights
Acute eosinophilic pneumonia (AEP) is a rare disorder, often resulting in acute respiratory failure with an attended mortality
AEP is characterized by the infiltration of pulmonary parenchyma with eosinophils and is often associated with peripheral eosinophilia [12]
We present a patient with AEP following therapy with daptomycin
Summary
Acute eosinophilic pneumonia (AEP) is a rare disorder, often resulting in acute respiratory failure with an attended mortality. A 65-year-old gentleman with past medical history significant for chronic kidney disease stage 3, liver cirrhosis, and thoracolumbar spinal stenosis presented to the hospital because of progressive dyspnea, fever, and non-productive cough for two days He underwent laminectomy for spinal stenosis, later complicated by T5-8 vertebral osteomyelitis with epidural phlegmon, requiring drainage and debridement with hardware removal. Bronchoscopy and bronchoalveolar lavage (BAL) were performed the day, which revealed an eosinophil count of >20% in lavage He was started on intravenous solumedrol and daptomycin was discontinued. AFB: acid-fast bacilli; BAL: bronchoalveolar lavage; ESR: erythrocyte sedimentation rate; WBC: white blood cell
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
