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Published on: July 12, 2018
[Possible daptomycin-induced organizing pneumonia]
Turid Snekloth Søndergaard1, Helga Schumacher, Kirsten Norup
1Klinisk Mikrobiologisk Afdeling, Regionshospitalet Herning, 7400 Herning, Denmark. turids@mail.tele.dk
Abstract:
We report a possible and rare case of drug-induced organizing pneumonia in a patient receiving daptomycin. A 75-year-old man with acute infective aorta valve endocarditis due to Enterococcus faecalis developed organizing pneumonia following treatment with intravenous daptomycin and ceftriaxone. The patient could have acquired an infectious agent which was resistant to ceftriaxone, such as Legionella, and he was thus treated with ciprofloxacin and rifampicin. However, no antigen was found in the urine, and the patient's symptoms subsided after daptomycin was discontinued.
Insights
A rare case of drug-induced organizing pneumonia occurred in a patient treated with daptomycin for aortic valve endocarditis. Symptoms resolved after discontinuing daptomycin, suggesting a link between the antibiotic and the lung condition.
Area of Science:
- Pulmonology
- Infectious Diseases
- Pharmacology
Background:
- A 75-year-old male presented with acute infective aortic valve endocarditis caused by Enterococcus faecalis.
- The patient was treated with intravenous daptomycin and ceftriaxone.
- A potential secondary infection with a ceftriaxone-resistant organism, such as Legionella, was considered.
Observation:
- The patient developed organizing pneumonia during daptomycin therapy.
- Symptoms of pneumonia emerged following the initiation of antibiotic treatment.
- No Legionella antigen was detected in urine samples.
Findings:
- Discontinuation of daptomycin led to the resolution of organizing pneumonia symptoms.
- The clinical presentation suggests a possible drug-induced organizing pneumonia.
- Ceftriaxone and subsequent ciprofloxacin/rifampicin treatments did not appear to be the primary cause.
Implications:
- This case highlights a rare adverse reaction to daptomycin, specifically organizing pneumonia.
- Clinicians should consider drug-induced lung injury in patients presenting with new respiratory symptoms during daptomycin treatment.
- Further investigation into the mechanisms of daptomycin-induced pulmonary toxicity may be warranted.
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