Ohnishi Hiroshi, Abe Masahiro, Yokoyama Akihito, Hamada Hironobu, Ito Ryoji, Hirayama Takeru, Nishimura Kazutaka, Higaki Jitsuo
Second Department of Internal Medicine, Ehime University School of Medicine, Ehime.
Intern Med. 2004 Mar;43(3):231-5. doi: 10.2169/internalmedicine.43.231.
Clarithromycin (CAM) has been widely used for the treatment of respiratory infection. Macrolides are generally well tolerated and their adverse reactions are rare. An 80-year-old woman with nontuberculous mycobacterium infection was treated with combined chemotherapy, including isoniazid, rifampicin, and ethambutol. She developed a fever and peripheral blood eosinophilia, and new subpleural consolidations were observed on chest radiography three days after add-on therapy with CAM. The symptoms and clinical findings improved with the withdrawal of CAM. Histopathologic examinations confirmed the diagnosis of eosinophilic pneumonia. This is the first report of CAM-induced eosinophilic pneumonia.
克拉霉素（CAM）已被广泛用于治疗呼吸道感染。大环内酯类药物一般耐受性良好，不良反应罕见。一名80岁的非结核分枝杆菌感染女性接受了包括异烟肼、利福平及乙胺丁醇在内的联合化疗。在加用CAM治疗三天后，她出现发热和外周血嗜酸性粒细胞增多，胸部X线检查发现新的胸膜下实变。停用CAM后，症状和临床检查结果有所改善。组织病理学检查确诊为嗜酸性粒细胞性肺炎。这是关于CAM诱发嗜酸性粒细胞性肺炎的首例报告。
