[Azithromycin-induced diffuse alveolar hemorrhage].
Susumu Sakamoto1, Kyohei Kaburaki, Kyoko Gochyo
1Department of Respiratory Medicine, Toho University School of Medicine.
Summary
Azithromycin (AZM), a common respiratory infection treatment, can rarely cause diffuse alveolar hemorrhage. This case highlights recurrent alveolar hemorrhage in a patient after repeated AZM administration.
Area of Science:
- Pulmonology
- Pharmacology
Background:
- Azithromycin (AZM) is a widely prescribed macrolide antibiotic for respiratory infections.
- Adverse reactions to macrolides are generally rare, contributing to their frequent use.
Observation:
- A 78-year-old male presented with bloody sputum and diffuse ground glass opacities on imaging after AZM treatment.
- Bronchoalveolar lavage confirmed bloody fluid, and symptoms improved with corticosteroid therapy.
- A similar event occurred a year prior after AZM treatment, initially diagnosed as interstitial lung disease.
Findings:
- Recurrent alveolar hemorrhage was diagnosed, strongly linked to azithromycin re-administration.
- This represents the first reported case of azithromycin-induced diffuse alveolar hemorrhage.
Implications:
- Clinicians should consider azithromycin as a potential cause of diffuse alveolar hemorrhage, especially with recurrent episodes.
- This case underscores the importance of thorough medication history in diagnosing rare adverse drug reactions.
- Further investigation into the mechanisms of azithromycin-induced pulmonary toxicity may be warranted.
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