Imipenem/cilastatin-induced acute eosinophilic pneumonia: A case report

Abstract

Rationale: Acute eosinophilic pneumonia (AEP) is an acute pulmonary illness caused by eosinophilic infiltration of the lung parenchyma. It can happen after using drugs such as daptomycin and minocycline. AEP induced by imipenem/cilastatin is a rare condition. Patient's Concern: A 45-year-old male patient, who previously suffered from a urinary tract infection and treated with imipenem/cilastatin antibiotic, was presented to us with acute respiratory distress, soon after the initiation of the antibiotic. Computed tomography identified pulmonary infiltrates in the upper and middle lung fields and eosinophils were found to account for 36% of differential count of the broncho-alveolar lavage fluid. He also developed peripheral eosinophilia as the disease progressed. Diagnosis: AEP, secondary to imipenem/cilastatin therapy. Interventions: Steroid therapy was administered and imipenem/cilastatin antibiotic was discontinued. Outcomes: The patient improved completely following the therapy and had clear lung fields on follow-up. Lessons: Imipenem/cilastatin is an uncommon cause of AEP and requires close monitoring during therapy.