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Vancomycin-Induced Organizing Pneumonia: A Case Report and Literature Review
1Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, 23, Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea.
Abstract:
The long-term administration of vancomycin has increased; however, the pulmonary adverse reactions of long-term vancomycin treatment remain under-studied. A 75-year-old male patient with vertebral osteomyelitis receiving long-term vancomycin therapy developed a fever. High resolution computed tomography showed irregular ground glass opacity and consolidation in the right upper lung. The patient developed organizing pneumonia. This occurred without peripheral eosinophilia or adverse reactions in the skin and liver. The administration of vancomycin was discontinued. He recovered from organizing pneumonia after four weeks of steroid therapy. Solitary organizing pneumonia can develop during treatment with vancomycin. When pulmonary inflammation occurs and other causes of pneumonia are excluded, vancomycin therapy should be discontinued.
Insights
Long-term vancomycin use can cause organizing pneumonia, a rare lung condition. Discontinuing vancomycin and using steroids can effectively treat this adverse reaction.
Area of Science:
- Pulmonology
- Infectious Diseases
- Pharmacology
Background:
- Long-term vancomycin administration is increasing.
- Pulmonary adverse reactions to vancomycin are under-studied.
Observation:
- A 75-year-old male on long-term vancomycin for vertebral osteomyelitis presented with fever.
- High-resolution computed tomography revealed lung consolidation and ground glass opacity.
- The patient was diagnosed with organizing pneumonia without eosinophilia or other organ involvement.
Findings:
- Vancomycin treatment was discontinued, leading to recovery.
- Steroid therapy resolved the organizing pneumonia within four weeks.
- This case suggests solitary organizing pneumonia can be a vancomycin-induced adverse reaction.
Implications:
- Clinicians should consider vancomycin-induced organizing pneumonia in patients with unexplained pulmonary inflammation.
- Discontinuation of vancomycin is crucial for managing this adverse event.
- Further research is needed to understand the incidence and mechanisms of vancomycin-related pulmonary toxicity.
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