Clinical evaluation of 12 cases of antimicrobial drug-induced pneumonitis.
The diagnosis of drug-induced pneumonitis is generally difficult, and it is made clinically by Tamura's criteria. We experienced 12 cases (7 definite and 5 possible cases) of antimicrobial drug-induced pneumonitis (one of case was the first case caused by carbapenem). Symptoms such as fever (11/12), cough (10/12) and dyspnea (10/12) and laboratory data such as eosinophilia (7/12), elevation of IgE (4/6) and hypoxia (11/12) were commonly seen in these patients, although they were not specific. Lymphocyte stimulation test (5/11) and provocation test (4/8) were quite suggestive of drug allergy. Bronchoscopy has been used for confirmation of pneumonitis. Transbronchial lung biopsy revealed alveolitis (4/9) or alveolar fibrosis (3/9), and bronchoalveolar lavage showed lymphocytosis (6/6) and depression of OKT4/T8 ratio (3/5). The combination of bronchoscopic and immunological examinations were more confirmative for diagnosis.
Kohno
S
S
Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
Yamaguchi
K
K
Yasuoka
A
A
Koga
H
H
Hayashi
T
T
Komori
K
K
Hara
K
K
D000328:Adult; D000368:Aged; D000667:Ampicillin / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001992:Bronchoalveolar Lavage Fluid; D002511:Cephalosporins / Q000009:adverse effects; D015377:Cilastatin / Q000009:adverse effects; D002981:Clindamycin / Q000009:adverse effects; D005260:Female; D006801:Humans; D015378:Imipenem / Q000009:adverse effects; D007958:Leukocyte Count; D008168:Lung / Q000000981:diagnostic imaging; D008213:Lymphocyte Activation / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000009:adverse effects; D015242:Ofloxacin / Q000009:adverse effects; D011014:Pneumonia / Q000139:chemically induced* / Q000175:diagnosis; D011859:Radiography; D012293:Rifampin / Q000009:adverse effects
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D015377:Cilastatin; D002981:Clindamycin; D015378:Imipenem; D000667:Ampicillin; D015242:Ofloxacin; D008911:Minocycline; D012293:Rifampin