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Ciprofloxacin-induced acute interstitial pneumonitis
D Steiger1, L Bubendorf, M Oberholzer
1Dept of Internal Medicine, University Hospital, Basel, Switzerland.
The European Respiratory Journal
|January 24, 2004
Summary
Ciprofloxacin, an antibiotic for urinary tract infections, can cause severe lung injury and respiratory failure. Prompt diagnosis and corticosteroid treatment are crucial for recovery from this rare adverse effect.
Area of Science:
- Pulmonology
- Pharmacology
- Infectious Diseases
Background:
- Urinary tract infections (UTIs) are common and frequently treated with antibiotics.
- Ciprofloxacin is a widely prescribed fluoroquinolone antibiotic for UTIs.
- Severe adverse drug reactions, though rare, necessitate careful monitoring.
Observation:
- A 68-year-old female developed severe respiratory failure six days after starting ciprofloxacin for a UTI.
- Clinical presentation included fever, dyspnea, hypoxemia, and radiographically evident interstitial lung disease.
- Bronchoalveolar lavage showed lymphocytosis, and extensive testing for infections was negative.
Findings:
- High-resolution computed tomography (HRCT) revealed progressive interstitial lung disease.
- Open lung biopsy confirmed hypersensitivity pneumonitis.
- Symptoms rapidly resolved with systemic corticosteroid therapy, and HRCT showed complete remission of pulmonary infiltrates.
Implications:
- Ciprofloxacin can induce interstitial pneumonitis, leading to acute respiratory failure.
- This highlights the importance of considering drug-induced lung disease in patients presenting with respiratory symptoms after antibiotic initiation.
- Awareness of this potential adverse effect is critical for clinicians managing UTIs.