Daptomycin and acute lung injury: recognising drug-induced eosinophilic pneumonia

Daptomycin-induced eosinophilic pneumonia (DIEP) is a rare medication adverse event that can lead to severe respiratory distress and clinical decompensation. Herein, we report a man in his 70s who was being treated with outpatient intravenous daptomycin for foot osteomyelitis and presented with fevers and shortness of breath. His clinical exam and imaging favoured an infectious pneumonia. However, the patient's respiratory and clinical status continued to decline despite broad-spectrum antibiotics. A diagnosis of DIEP was established by elevated peripheral eosinophil count and >25% eosinophils on bronchoalveolar lavage. The patient's clinical status improved after discontinuing daptomycin and initiating systemic corticosteroid therapy.