Clarithromycin-induced Eosinophilic Pneumonia

Hiroshi OHNISHI; Masahiro ABE; Akihito YOKOYAMA; Hironobu HAMADA; Ryoji ITO; Takeru HIRAYAMA; Kazutaka NISHIMURA; Jitsuo HIGAKI

doi:10.2169/internalmedicine.43.231

Respiratory Diseases

Clarithromycin-induced Eosinophilic Pneumonia

Hiroshi OHNISHI, Masahiro ABE, Akihito YOKOYAMA, Hironobu HAMADA, Ryoji ITO, Takeru HIRAYAMA, Kazutaka NISHIMURA, Jitsuo HIGAKI

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Keywords: drug-induced pneumonitis, eosinophilia, macrolides, eosinophilic cationic protein, interleukin-5, nontuberculous mycobacterium infection

JOURNAL OPEN ACCESS

2004 Volume 43 Issue 3 Pages 231-235

DOI https://doi.org/10.2169/internalmedicine.43.231

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Abstract

Clarithromycin (CAM) has been widely used for the treatment of respiratory infection. Macrolides are generally well tolerated and their adverse reactions are rare. An 80-year-old woman with nontuberculous mycobacterium infection was treated with combined chemotherapy, including isoniazid, rifampicin, and ethambutol. She developed a fever and peripheral blood eosinophilia, and new subpleural consolidations were observed on chest radiography three days after add-on therapy with CAM. The symptoms and clinical findings improved with the withdrawal of CAM. Histopathologic examinations confirmed the diagnosis of eosinophilic pneumonia. This is the first report of CAM-induced eosinophilic pneumonia.

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