SHM Converge Scientific Abstract ePoster Gallery-Hospital-Acquired but Non-Infectious: A Case of Daptomycin-Induced Acute Eosinophilic Pneumonia

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A 68-year-old man with poorly controlled type 2 diabetes was hospitalized after partial fifth ray resection for MRSA osteomyelitis and treated with IV daptomycin because of a vancomycin allergy. Several days later, he developed recurrent fevers, dyspnea, hypoxia, and bilateral ground-glass opacities with lower-lobe consolidation on chest CT, initially raising concern for hospital-acquired pneumonia. Infectious workup, including blood and sputum cultures, COVID-19 testing, respiratory viral panel, and legionella antigen, was negative. Despite cefepime, he continued to have oxygen needs, fevers, and rising white blood cell count with a marked increase in eosinophils.<br /><br />Given the pattern and concern for daptomycin-induced acute eosinophilic pneumonia, daptomycin was stopped and pulmonology was consulted. A prior similar episode 15 years earlier while on daptomycin was identified, strengthening the diagnosis. Bronchoalveolar lavage was deferred because the clinical picture was convincing and the patient improved rapidly after drug discontinuation. Steroids were considered but not used due to spontaneous improvement. He was discharged on oral linezolid, and his leukocytosis and eosinophilia normalized within three weeks.<br /><br />The report emphasizes that this case meets criteria for a probable diagnosis of daptomycin-induced acute eosinophilic pneumonia. Typical features include fever, dyspnea, hypoxia, new lung infiltrates, peripheral eosinophilia, and improvement after stopping daptomycin. Most reported cases occur in older men treated for osteomyelitis. Clinicians should recognize this rare but important adverse effect, since prompt discontinuation of daptomycin can lead to recovery even without corticosteroids.

Asset Subtitle

Wilton P. Smith

Meta Tag

Author List Celeste Christensen, Jessica Cyr, Wilton P. Smith

Category Clinical Vignettes

Concept Daptomycin-induced acute eosinophilic pneumonia

Concept Daptomycin

Concept Eosinophilia

Concept Drug Discontinuation

Concept Dyspnea

Distinguished Non-Finalist

Presenter Organization University of Pittsburgh Medical Center

Presenting Author Wilton P. Smith

Track Adult

Keywords

daptomycin

acute eosinophilic pneumonia

MRSA osteomyelitis

type 2 diabetes

hypoxia

ground-glass opacities

peripheral eosinophilia

drug-induced lung injury

linezolid

bronchoalveolar lavage

Daptomycin-induced acute eosinophilic pneumonia

Daptomycin

Eosinophilia

Drug Discontinuation

Dyspnea