达托霉素诱发的急性嗜酸性粒细胞肺炎的诊断与处理:病例报告。

Innovations in pharmacy Pub Date : 2024-05-31 eCollection Date: 2024-01-01 DOI:10.24926/iip.v15i2.6200
Fawzy Elbarbry, Kate Farthing, Shannon Arguello
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引用次数: 0

摘要

达托霉素是一种环脂肽抗生素,适用于治疗革兰氏阳性菌引起的复杂皮肤感染和菌血症。急性嗜酸性粒细胞肺炎(AEP)是达托霉素的一种罕见但严重的不良反应,由肺组织中的嗜酸性粒细胞聚集引起,可导致呼吸衰竭。早期诊断和治疗对避免严重并发症(包括死亡)至关重要。在此,我们报告了一例老年男性患者的病例,他在开始使用达托霉素治疗 MRSA 菌血症的两周内出现了 AEP 的症状和体征。停用达托霉素并开始为期 5 天的类固醇治疗后,患者的临床症状明显好转,嗜酸性粒细胞也有所下降。急性嗜酸性粒细胞肺炎是达托霉素可能产生的不良反应,尽管这种情况很少见,但仍应引起注意。可以通过典型症状、嗜酸性粒细胞增多和胸部X光片显示肺部浸润来进行早期识别。迅速停用达托霉素,并辅以类固醇治疗和支持性护理,通常可使患者的临床症状明显缓解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnosis and Management of Daptomycin-Induced Acute Eosinophilic Pneumonia: A Case Report.

Daptomycin is a cyclic lipopeptide antibiotic that is indicated for the treatment of complicated skin infections and bacteremia caused by gram positive organisms. Acute eosinophilic pneumonia (AEP) is a rare, but serious adverse effect of daptomycin and caused by accumulation of eosinophils in the lung tissues, and can lead to respiratory failure. Early diagnosis and management of this condition is crucial to avoid severe complications, including death. Herein, we report a case of an elderly man who presented with signs and symptoms of AEP within two weeks of initiation of daptomycin for the treatment of MRSA bacteremia. The patient showed significant clinical improvement and decline in eosinophils upon discontinuation of daptomycin and starting a 5-day steroid course. Acute eosinophilic pneumonia should be kept in mind as a possible, although rare, adverse effect of daptomycin. Early recognition can be established through typical symptoms, eosinophilia, and chest X-ray showing pulmonary infiltrate. Rapid discontinuation of daptomycin with/without steroid therapy and supportive care usually results in significant clinical recover.

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