Abstract
IntroductionAlthough several studies did not demonstrate that daptomycin may cause significantly higher rates of pulmonary adverse effects when compared with vancomycin or penicillinase-resistant penicillins, there have been a few case reports of severe pulmonary complications associated with daptomycin administration.Case presentationA rare case of eosinophilic pneumonia occurring 10 days after daptomycin administration in a 78-year-old Caucasian man with possible infectious endocarditis is described. He developed new onset fever, up to 38.5°C, with bilateral pulmonary crackles on physical examination and with no signs of severe respiratory failure. A chest computed tomography-scan showed bilateral nodular consolidations with air bronchograms and pleural effusions. Immediate discontinuation of daptomycin was followed by vigorous improvement of clinical signs and symptoms with progressive resolution of pulmonary consolidations a month later.ConclusionPhysicians should be aware of this rare but serious complication during daptomycin treatment, and prompt discontinuation of the offending agent, with or without additional supportive treatment, must occur immediately.
Highlights
Several studies did not demonstrate that daptomycin may cause significantly higher rates of pulmonary adverse effects when compared with vancomycin or penicillinase-resistant penicillins, there have been a few case reports of severe pulmonary complications associated with daptomycin administration.Case presentation: A rare case of eosinophilic pneumonia occurring 10 days after daptomycin administration in a 78-year-old Caucasian man with possible infectious endocarditis is described
Daptomycin has a favorable adverse effect summary, and even though several retrospective studies did not show significantly increased incidence of pulmonary adverse drug reactions when compared to other anti-microbial agents [4,5,6,7], recently published case reports pointed out serious respiratory complications associated with daptomycin [8,9,10,11]
We present a case of pulmonary infiltrates and broncho-alveolar lavage eosinophilia occurring during treatment with daptomycin in a patient with possible infectious endocarditis (IE)
Summary
Eosinophilic pneumonia (EP) belongs to a heterogeneous group of lung diseases characterized by pulmonary infiltrates and increased numbers of eosinophils in lung tissue or broncho-alveolar lavage (BAL) fluid, with or without increased levels of eosinophils in the peripheral blood [1]. We present a case of pulmonary infiltrates and broncho-alveolar lavage eosinophilia occurring during treatment with daptomycin in a patient with possible infectious endocarditis (IE). In this particular case, and in contrast to previously published reports, our patient did not develop severe respiratory failure, and direct discontinuation of daptomycin without the systemic. The fever resolved and no other clinical manifestations developed until the day of admission to our hospital Regarding his past medical history, he was a non-smoker, he had no known allergies and he did not mention any recent travels. The Naranjo causality scale yielded a score of 7 suggesting a probable adverse reaction due to daptomycin [12]
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