著者
Yoshitsugu Higashi Shigeki Nakamura Yasuhiro Tsuji Chika Ogami Kaoru Matsumoto Koyomi Kawago Kotaro Tokui Ryuji Hayashi Ippei Sakamaki Yoshihiro Yamamoto
出版者
The Japanese Society of Internal Medicine
雑誌
Internal Medicine (ISSN:09182918)
巻号頁・発行日
vol.57, no.2, pp.253-258, 2018-01-15 (Released:2018-01-15)
参考文献数
31
被引用文献数
18

A 53-year-old man was admitted to the hospital with a diagnosis of cellulitis and osteomyelitis. Twenty-four days after the initiation of daptomycin and sulbactam/ampicillin, he developed a fever and pulmonary infiltration. Bronchoalveolar lavage revealed a high number of eosinophils, while an intracutaneous test revealed positivity for daptomycin. The patient improved after discontinuing antimicrobial therapy. The plasma daptomycin minimum concentration (Cmin) was elevated (27.4 μg/mL), but plasma protein binding of daptomycin was low (87.8%). Although the pathophysiology of eosinophilic pneumonia remains unclear, antigenic stimulation due to daptomycin accumulation in the alveoli may have caused continuous immune activation.