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一个应该引起注意的肺部浸润罕见病因:一例达托霉素诱导的急性嗜酸性肺炎。

A rare cause of pulmonary infiltrates one should be aware of: a case of daptomycin-induced acute eosinophilic pneumonia.

机构信息

Medical University Department, Kantonsspital Aarau, Tellstrasse, 5001 Aarau, Switzerland.

出版信息

Infection. 2011 Dec;39(6):583-5. doi: 10.1007/s15010-011-0148-y. Epub 2011 Jun 30.

Abstract

We report a 69-year-old patient who developed fever and dyspnea 3 weeks after the initiation of daptomycin therapy for spondylodiscitis with lumbar epidural and bilateral psoas abscesses due to ampicillin- and high-level-gentamicin-resistant Enterococcus faecium. There was profound hypoxia and the chest X-ray showed extensive patchy infiltrates bilaterally. A bronchoalveolar lavage revealed 30% eosinophils and results of microbiological studies were normal. Daptomycin-induced eosinophilic pneumonia was diagnosed and the patient rapidly improved after the discontinuation of daptomycin and a brief course of prednisone. Increased attention must be paid to this rare but serious side effect of daptomycin.

摘要

我们报告了 1 例 69 岁患者,因氨苄西林和高水平庆大霉素耐药粪肠球菌导致的腰椎脊椎炎合并腰椎硬膜外和双侧腰大肌脓肿,在开始使用达托霉素治疗后 3 周出现发热和呼吸困难。患者存在严重低氧血症,胸部 X 线片显示双侧弥漫性斑片状浸润。支气管肺泡灌洗液显示 30%的嗜酸性粒细胞,微生物学研究结果正常。诊断为达托霉素诱导的嗜酸性粒细胞性肺炎,停用达托霉素和短期泼尼松治疗后患者迅速好转。必须更加关注达托霉素这种罕见但严重的副作用。

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