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Case Reports
. 2015 May 30:15:110-4.
doi: 10.1016/j.rmcr.2015.05.013. eCollection 2015.

Minocycline-induced acute eosinophilic pneumonia: A case report and review of the literature

Sharon W Hung  1
Affiliations
Case Reports

Minocycline-induced acute eosinophilic pneumonia: A case report and review of the literature

Sharon W Hung. Respir Med Case Rep. .

Abstract

Acute eosinophilic pneumonia (AEP) can be a challenging diagnosis and is often initially misdiagnosed as one of the more common pneumonia syndromes such as acute respiratory distress syndrome. Early bronchoalveolar lavage (BAL) is critical in distinguishing the diagnosis to initiate proper management. The etiology of AEP is unknown, though many drugs have been implicated, including minocycline. Minocycline is commonly used for pneumonia, acute bronchitis, urinary tract infections, and acne and is likely the cause of AEP in our patient. There are 26 case reports of minocycline-induced AEP. In most cases, outcomes were favorable and symptoms rapidly resolved upon discontinuation of minocycline, with 11 cases employing steroids, one case twelve hours of CPAP and another 5 days of intubation. None resulted in mortality. Although it is difficult to evaluate without further studies, steroids should be recommended for minocycline-induced AEP, especially for those with severe or persistent symptoms.

Keywords: Acute eosinophilic pneumonia; Corticosteroids; Minocycline; Pulmonary eosinophilia; Tetracycline.

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Figures

Image 1
Image 1
Admission Chest Radiograph demonstrated small bilateral effusions and bilateral upper lobe lung infiltrates.
Image 2
Image 2
Computed tomography of the chest revealed diffuse bilateral airspace disease with ground glass attenuation involving all lobes along with moderate bilateral pleural effusions.
Image 3
Image 3
Computed tomography of the chest revealed diffuse bilateral airspace disease with ground glass attenuation involving all lobes along with moderate bilateral pleural effusions.
Image 4
Image 4
Three weeks after oral steroid therapy, marked resolution of bilateral infiltrates and improvement of bilateral effusions are seen.
See this image and copyright information in PMC

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