Abstract
The long-term administration of vancomycin has increased; however, the pulmonary adverse reactions of long-term vancomycin treatment remain under-studied. A 75-year-old male patient with vertebral osteomyelitis receiving long-term vancomycin therapy developed a fever. High resolution computed tomography showed irregular ground glass opacity and consolidation in the right upper lung. The patient developed organizing pneumonia. This occurred without peripheral eosinophilia or adverse reactions in the skin and liver. The administration of vancomycin was discontinued. He recovered from organizing pneumonia after four weeks of steroid therapy. Solitary organizing pneumonia can develop during treatment with vancomycin. When pulmonary inflammation occurs and other causes of pneumonia are excluded, vancomycin therapy should be discontinued.
Highlights
Vancomycin is a tricyclic glycopeptide antibiotic that is used as a first line agent for many infections, including bacteraemia, endocarditis, pneumonia, cellulitis, osteomyelitis, caused by methicillin-resistant Staphylococcus aureus, and coagulase-negative Staphylococcus infections [1]
Previous case reports have shown that pulmonary adverse effects may occur with vancomycin-induced drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome [3]
This study was approved by the Institutional Review Board (KHUH-2020-07-039; 16 July 2020) of Kyung Hee University Hospital, Seoul, Korea, which waived the need for written informed consent from the patient
Summary
Vancomycin is a tricyclic glycopeptide antibiotic that is used as a first line agent for many infections, including bacteraemia, endocarditis, pneumonia, cellulitis, osteomyelitis, caused by methicillin-resistant Staphylococcus aureus, and coagulase-negative Staphylococcus infections [1]. This drug is associated with several adverse drug reactions such as nephrotoxicity, infusion-related events, ototoxicity, and hypersensitivity reactions [1]. As the incidence of vertebral osteomyelitis, primarily caused by S. aureus increases, long-term administration of vancomycin increases [2]. The adverse effects of long-term vancomycin treatment remain under-studied. We describe a case of organizing pneumonia caused by long-term treatment with vancomycin. This study was approved by the Institutional Review Board (KHUH-2020-07-039; 16 July 2020) of Kyung Hee University Hospital, Seoul, Korea, which waived the need for written informed consent from the patient
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