P95 | Not an infection, but a complication of antibiotic therapy: daptomycin acute eosinophilic pneumonia
Year: 2025
Type: article
Study design: Case Report
Abstract: Background: Daptomycin therapy is a leading cause of acute eosinophilic pneumonia (AEP), a rare but significant condition in Internal Medicine. It can manifest as acute respiratory failure, fever, and eosinophilia. Case report: Patient is a 78 years old woman admitted for antibiotic treatment of MSSA sepsis complicated by osteomyelitis, prosthetic aortic valve endocarditis, and lung abscesses. She was treated with daptomycin 700 mg/day and ceftaroline 600 mg x 3. Following the removal of the prosthetic valve, clinical improvement was observed, with a decrease in fever, leukocytosis, CRP/PCT, and improved respiratory function.After one week of antibiotic therapy, an increase in eosinophil count (19.6%, 2360/µL) and CRP levels (2 ->25 mg/dL) was noted. Due to suspicion of an allergic reaction, empiric steroid therapy was initiated. Bacterial, fungal, and helminthic infections were ruled out. Bronchoalveolar lavage revealed 81% of eosinophils.The patient experienced acute dyspnea, respiratory failure and fever during the night, which required NIMV. A CT scan showed multifocal pneumonia with both interstitial honeycombing and consolidations. Based on these findings, a diagnosis of AEP was made. Steroids were increased (methylprednisolone 1 mg/kg/day) and daptomycin was discontinued. Over the next three days, there was a rapid improvement which allowed for the suspension of NIMV and reduction of consolidations seen on the chest X-ray. Normalization of the eosinophil count was observed after just two day of steroid therapy. A chest X-ray performed one week later documented complete resolution of the AEP.
Source: Italian Journal of Medicine
Authors: Vo Van Kha, Tran Thi Huong Ly, Pham Thi Thanh Hoa, Vo Huynh Nhu, Damas Hendriansyah, Nusratuddin Abdullah, Rudy B. Leonardy, Mardiah Tahir, Samrichard Rambulangi, Firdaus Hamid, Filomena Pietrantonio, Vera Kopsaj, Francesco Rosiello, Aurora Tomassoni, Luca Moriconi, Donatella Padua, Kiki Rizki Amelia, Efendi Lukas, Nurbani Bangsawan, Isharyah Sunarno, Retno Budiarti Farid, Sriwijaya Qadar, Rabab H. Elshaikh, Ashok Kumar Sah, Abdelrahman Mohamed Abukanna, Abdulrahman Algarni, Ammar Abdelmola, Hussam Ali Osman, Tagwa Yousif Elsayed Yousif, Elryah I. Ali, Hiba Ali, Ayman Hussein Alfeel, Thanh Long Nguyen, Victor Storm, Lam Toi Phung, Cong Thien Le, Thi Thu Ha Le, Thi Hoa Nguyen, Son Tung Vu, Thien Thang Tran, Minh Hanh Vu, Van Tuan Nguyen, Francesco Ventrella, Anna Belfiore, Antonio Greco, Franco Mastroianni, Salvatore Lenti, Domenico Ruggiero, Michele Cannone, Vincenzo Ostilio Palmieri, Massimo Errico, Giuseppe Mancia, Guido Grassi, Sverre E. Kjeldsen
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4413684768