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与达托霉素相关的嗜酸性粒细胞性肺炎:一例病例报告及文献综述

Eosinophilic pneumonia associated with daptomycin: a case report and a review of the literature.

作者信息

Kalogeropoulos Andreas S, Tsiodras Sotirios, Loverdos Dionysios, Fanourgiakis Panagiotis, Skoutelis Athanasios

机构信息

5th Department of Internal Medicine and Infectious Diseases, "EVANGELISMOS" General Hospital, 45-47 Ipsilantou Street, 106 76 Kolonaki, Athens, Greece.

出版信息

J Med Case Rep. 2011 Jan 17;5:13. doi: 10.1186/1752-1947-5-13.

Abstract

INTRODUCTION

Although 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. 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.

CONCLUSION

Physicians 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.

摘要

引言

尽管多项研究并未表明与万古霉素或耐青霉素酶青霉素相比,达托霉素可能导致更高的肺部不良反应发生率,但已有一些与达托霉素给药相关的严重肺部并发症的病例报告。

病例介绍

描述了1例78岁白人男性在接受达托霉素治疗10天后发生嗜酸性粒细胞性肺炎的罕见病例,该患者可能患有感染性心内膜炎。他出现了新的发热,体温高达38.5°C,体格检查发现双侧肺部有啰音,且无严重呼吸衰竭的迹象。胸部计算机断层扫描显示双侧结节状实变伴空气支气管征和胸腔积液。立即停用达托霉素后,临床体征和症状迅速改善,1个月后肺部实变逐渐消退。

结论

医生应意识到达托霉素治疗期间这种罕见但严重的并发症,必须立即停用致病药物,无论是否进行额外的支持治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77fb/3033840/029a8431e091/1752-1947-5-13-1.jpg

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