Alarming Eosinophilia From Dobutamine Infusion.

Area of Science:

• Cardiology
• Pharmacology
• Hematology

Background:

• Cardiogenic shock necessitates aggressive inotropic support.
• Dobutamine is a common inotrope used in heart failure management.
• Patient presented with nonischemic heart failure with reduced ejection fraction, hypertension, and diabetes.

Observation:

• High-dose dobutamine infusion was initiated for cardiogenic shock.
• Despite improved volume status, the patient developed fever and hypotension.
• Severe eosinophilia was identified as the cause of clinical deterioration.

Findings:

• Dobutamine-induced eosinophilia is a rare but serious adverse effect.
• Eosinophilia significantly worsened the patient's already decompensated state.
• Cessation of dobutamine and administration of steroids led to resolution.

Implications:

• Clinicians should be aware of dobutamine-induced eosinophilia in heart failure patients.
• Monitoring for eosinophilia may be warranted in patients on high-dose dobutamine.
• This case highlights a critical drug-induced complication in critical care settings.