Van Oortegem A, Meurice J-C, Verdaguer M, Bironneau V
Service de pneumologie, Centre Hospitalier Universitaire, 6, rue de la Milétrie, 86000 Poitiers, France.
Service de pneumologie, Centre Hospitalier Universitaire, 6, rue de la Milétrie, 86000 Poitiers, France.
Rev Mal Respir. 2021 May;38(5):524-529. doi: 10.1016/j.rmr.2021.03.010. Epub 2021 Apr 24.
Acute eosinophilic pneumonia (AEP) is a rare and potentially severe disorder, characterized by an acute febrile respiratory illness with diffuse pulmonary infiltrates, pleural effusions and an eosinophilic alveolitis identified on broncho-alveolar lavage or lung biopsy. The condition can be idiopathic, or induced by the inhalation of toxic substances, by infections or by medications. The condition tends to respond rapidly to treatment with systemic steroids.
We report the case of a 16-year old patient who presented severe acute interstitial pneumonia with eosinophilia (1.17g/L). They had taken a seven-day course of amoxicillin treatment two weeks previously for a dental abscess. The patient initially required respiratory support by mechanical ventilation followed by extracorporeal membrane oxygenation due to severe refractory hypoxemia. After exhaustive investigation a diagnosis of amoxicillin-induced acute eosinophilic pneumonia was made. After steroid treatment was initiated the clinical response was rapidly favorable and remission was achieved. The patient has been advised to avoid beta lactam antibiotics for life.
This case illustrates a rare case of severe acute eosinophilic pneumonia induced by amoxicillin.
急性嗜酸性粒细胞性肺炎(AEP)是一种罕见且可能严重的疾病,其特征为急性发热性呼吸道疾病,伴有弥漫性肺部浸润、胸腔积液以及在支气管肺泡灌洗或肺活检中发现嗜酸性粒细胞性肺泡炎。该病症可为特发性,或由吸入有毒物质、感染或药物诱发。该病症往往对全身用类固醇治疗反应迅速。
我们报告一例16岁患者,其表现为严重的急性间质性肺炎伴嗜酸性粒细胞增多(1.17g/L)。两周前,他们因牙脓肿接受了为期七天的阿莫西林治疗。患者最初因严重的难治性低氧血症需要机械通气进行呼吸支持,随后需要体外膜肺氧合。经过全面检查,诊断为阿莫西林诱发的急性嗜酸性粒细胞性肺炎。开始使用类固醇治疗后,临床反应迅速良好,实现了缓解。已建议该患者终身避免使用β-内酰胺类抗生素。
本病例说明了一例由阿莫西林诱发的严重急性嗜酸性粒细胞性肺炎的罕见病例。