SHM Converge Scientific Abstract ePoster Gallery-Acute Eosinophilic Pneumonia Due to Concomitant Use of Daptomycin and Ceftaroline

Pdf Summary

This case report describes a 55-year-old man with persistent MRSA bacteremia and septic pulmonary emboli who was treated with vancomycin, then switched to salvage therapy with daptomycin and ceftaroline because of ongoing bacteremia. Before discharge, he developed recurrent hypoxia despite being largely asymptomatic. Imaging showed diffuse bilateral airspace opacities and scattered ground-glass changes. His absolute eosinophil count was elevated, cultures were negative, and COVID-19 testing was negative.<br /><br />Because of concern for acute eosinophilic pneumonia (AEP), the antibiotic regimen was stopped and he was treated with intravenous methylprednisolone, later transitioned to oral prednisone. He briefly required ICU care and intubation but improved rapidly, with successful extubation within 48 hours of starting steroids.<br /><br />The authors conclude that the patient most likely developed AEP due to the concomitant use of daptomycin and ceftaroline. Although bronchoalveolar lavage showed only 10% eosinophils, below the classic diagnostic threshold of 25%, the diagnosis was supported by the clinical picture, medication exposure, and prompt steroid response. <br /><br />The report highlights that both daptomycin and ceftaroline have individually been associated with AEP, and this combination is used for resistant MRSA infections because of reported synergy and improved bacteremia clearance. However, clinicians should recognize that this combination can also cause a serious but treatable pulmonary adverse reaction.

Asset Subtitle

Sriram Gonakoti

Meta Tag

Author List Jeries Alsahoury, Khaldun Obeidat, Prasanth Lingamaneni, Sriram Gonakoti

Category Clinical Vignettes

Concept Daptomycin-induced acute eosinophilic pneumonia

Concept Daptomycin

Concept Respiratory Failure

Concept Ceftaroline

Concept Pulmonary Opacities

Distinguished Non-Finalist

Presenter Organization John H Stroger Jr. Hospital of Cook County

Presenting Author Sriram Gonakoti

Track Adult

Keywords

MRSA bacteremia

septic pulmonary emboli

daptomycin

ceftaroline

acute eosinophilic pneumonia

eosinophilia

ground-glass opacities

corticosteroid therapy

ICU intubation

pulmonary adverse reaction

Daptomycin-induced acute eosinophilic pneumonia

Daptomycin

Respiratory Failure

Ceftaroline

Pulmonary Opacities