SHM Converge Scientific Abstract ePoster Gallery-From Fighting Bugs, to Fighting Lungs: A Case of Daptomycin Eosinophilic Pneumonitis

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This case report describes a 77-year-old man who developed daptomycin-induced eosinophilic pneumonia (DIEP), a rare but serious complication of daptomycin therapy. He was receiving daptomycin for a postoperative spinal surgical site infection after L4-S1 fusion surgery. Thirteen days after starting treatment, he returned with fever, worsening shortness of breath, cough, and new oxygen requirement. Initial imaging suggested atypical pneumonia, so he was treated with broad-spectrum antibiotics, but his respiratory status continued to worsen, requiring ICU care and noninvasive ventilation.<br /><br />By day 23 of daptomycin therapy, DIEP was suspected because of progressive multifocal lung consolidations and fibrosis on CT scan. Bronchoscopy could not be performed due to high oxygen needs. Daptomycin was stopped and replaced with linezolid, and the patient was started on high-dose intravenous methylprednisolone. Over the next 10 days, his oxygen needs improved significantly, and his steroid dose was tapered. Thirty days after stopping daptomycin and starting steroids, chest CT showed marked improvement.<br /><br />The report highlights key features of DIEP: typical onset about 2–3 weeks after starting daptomycin, common symptoms of fever and dyspnea, frequent peripheral eosinophilia, and imaging findings such as bilateral infiltrates or ground-glass opacities. Diagnosis relies on clinical suspicion, exclusion of other causes, and improvement after stopping the drug. The case emphasizes the importance of early recognition and prompt discontinuation of daptomycin, with corticosteroids often helpful in severe cases.

Asset Subtitle

Giacomo Adoncecchi

Meta Tag

Author List Giacomo Adoncecchi, Meghan Sebasky, Sandeep Segar

Category Clinical Vignettes

Concept Daptomycin-induced acute eosinophilic pneumonia

Concept Dyspnea

Concept Hypoxemia

Concept Eosinophilia

Concept Drug Discontinuation

Distinguished Non-Finalist

Presenter Organization UC San Diego Health

Presenting Author Giacomo Adoncecchi

Track Adult

Keywords

daptomycin-induced eosinophilic pneumonia

DIEP

daptomycin

eosinophilic pneumonia

postoperative spinal infection

dyspnea

fever

corticosteroid therapy

ground-glass opacities

drug-induced lung injury

Daptomycin-induced acute eosinophilic pneumonia

Dyspnea

Hypoxemia

Eosinophilia

Drug Discontinuation