Table 2 Summary of 35 cases of presumed daptomycin-induced eosinophilic pneumonia

Kim [1] (2012)

63/F

MSSA spinal osteomyelitis

6

3

• Fever

• Cough, hypoxemia

• BAL = 60–70%

• Peripheral eosinophilia

• Elevated CPK

• DAP d/c

• Corticosteroids

Recovered

64/M

Osteomyelitis with bacteremia

5.7

4

• Fever

• Dyspnea, hypoxia

• BAL = 44%

• Peripheral eosinophilia

• Pulmonary infiltrates

• DAP d/c

Recovered

79/M

Endocarditis

6

6

• Fever, cough, night sweats

• Dyspnea requiring MV

• BAL = 9–13%

• Peripheral eosinophilia

• CT = ground glass opacities

• Lung biopsy = eosinophilic pneumonitis

• DAP d/c

• Corticosteroids

Improved

26/M

MRSA bacteremia

7.35

1.4

• Dyspnea requiring MV

• BAL not performed

• Peripheral eosinophilia

• Pulmonary infiltrates

• Eosinophils in tracheal aspirate

• DAP d/c

Improved

43/M

MRSA osteomyelitis

6

1–2

• Pleuritic pain

• Hypoxia requiring O₂

• BAL not performed

• Peripheral eosinophilia

• CT = bilateral infiltrates

• DAP d/c

• Given NSAIDs, meperidine

• Improved

• Residual infiltrates on CT s/p 4 wks

66/M

MSSA bacteremia

6

1

• Dyspnea requiring O₂

• Hematemesis

• BAL with eosinophils (not quantified)

• Peripheral eosinophilia

• DAP d/c

• Corticosteroids

Recovered

71/M

MRSA diabetic foot infection

4

7.7

• Dyspnea requiring O₂

• Peripheral eosinophilia

• Elevated CRP

• Elevated ESR

• CT = bilateral interstitial opacities

• DAP d/c

Improved

77/F

Bacteremia (enterococcal)

5

1

• Dyspnea requiring O₂

• Peripheral eosinophilia

• CXR = pneumonitis

• DAP d/c

• Corticosteroids

Improved

67/M

MRSA endocarditis

6

4.3

• Dyspnea requiring MV

• BAL = 9%

• Peripheral eosinophilia

• CT = bilateral pulmonary infiltrates

• DAP d/c

• Corticosteroids

Improved

73/M

Prosthetic joint infection

5

3.7

• Fever

• Dyspnea requiring MV

• Peripheral eosinophilia

• CT = bilateral ground glass appearance

• DAP d/c

• Corticosteroids

Recovered

81/F

MRSA paraspinal abscess

6

1.6

• Dyspnea requiring MV

• BAL = 2% (s/p corticosteroid)^a

• CXR = bilateral mid-lung infiltrates

• DAP d/c

• Corticosteroids

Improved

Cobb [6] (2007)

84/M

Infection of left knee prosthesis

4

4

• Decreased appetite

• Weight loss

• Fatigue

• Weakness

• Elevated ESR

• CT with infiltrates

• Lung biopsy = eosinophilic pneumonia

• DAP d/c

• Improved within 2 weeks

Hayes [7] (2007)

60/M

MSSA endocarditis

NR

2

• Fever, rigors, diaphoresis

• Required MV

• BAL 16% initially

• BAL 26% after rechallenge

• CRP elevated

• DAP d/c – then re-challenged

• DAP d/c plus corticosteroids

• Rechallenge failed within 4 h

• Improved within 24 h after DAP d/c

Kakish [8] (2008)

65/M

MRSA vertebral osteomyelitis, epidural abscess

6

2

• Low-grade fever

• Dyspnea requiring MV

• BAL = 33%

• Peripheral eosinophilia

• Lung biopsy revealed eosinophils

• DAP d/c

• Corticosteroids

• Improved within 72 h

• Normal CT at 3 months

Shinde [9] (2009)

54/M

Complicated inguinal hernia repair

NR

2

• Low grade fever, cough

• Hypoxemia requiring MV

• Peripheral eosinophilia

• CT = bilateral airspace, peripheral predominance, small bilateral effusions

• Lung biopsy = many eosinophils

• DAP d/c

• Corticosteroids

• Improved within 24 h

• Normal CT at 4 weeks

Lal [10] (2010)

82/M

Prosthetic joint infection

NR

3

• Fever

• Hypoxia requiring O₂

• BAL = 14%

• Peripheral eosinophilia

• CT = patchy bilateral infiltrates

• DAP d/c

• Corticosteroids

• Recovered after 5 days

• Recurrent symptoms

• Low dose steroids required

87/M

Prosthetic knee infection

NR

4

• Dyspnea, dry cough requiring O₂

• Malaise, chills, anorexia, fever

• BAL = 40%

• Peripheral eosinophilia

• CT = bilateral patchy pulmonary infiltrates

• DAP d/c

• Corticosteroids

• Recurrence s/p steroid taper

• Low dose steroids for 2 years

Miller [11] (2010)

60/M

MSSA prosthetic hip infection

6

2

• Cough, fever

• Hypoxia requiring O₂

• BAL = 81% after rechallenge

• Peripheral eosinophilia

• CT = bilateral scattered ground-glass opacities

• Lung biopsy = acute fibrinous and organizing pneumonia, reactive alveolar and interstitial epithelial changes

• DAP d/c

• Rechallenged, DAP d/c

• Corticosteroids

• Improved within 48 h

• Rechallenge failed within 24 h

60/M

MRSA osteomyelitis, septic arthritis

6

2

• Non-productive cough, dyspnea

• Low-grade fevers, chills

• Peripheral eosinophilia

• CT = patchy peripheral nodular/ground-glass

• DAP d/c

• Resolution within 96 h

• Recurrence with re-challenge at 5 months

83/M

Diskitis of lumbar spine

6

4

• Progressive dyspnea,

• Cough, pleuritic chest pain

• BAL = 13%

• Peripheral eosinophilia

• CT = diffuse ground-glass, reticular opacities

• Lung biopsy = acute organizing pneumonia, eosinophilia, chronic inflammation, fibro-inflammatory changes

• DAP d/c

• Corticosteroids

Improved within 6 days

Kalogeropoulous [12] (2011)

78/M

Endocarditis

8

1.4

• Fever, chills, diaphoresis,

• Hypoxemia requiring O₂

• BAL = 27.5%

• Peripheral eosinophilia

• Elevated ESR

• Elevated CRP

• CT = patchy consolidation, ground-glass opacities, bilateral pleural effusions

• DAP d/c

Resolution within 24 h

Rether [13] (2011)

69/M

Spondylo-discitis with lumbar epidural and bilateral psoas abscesses

6

3

• Fever

• Dyspnea requiring O₂

• BAL = 30%

• Elevated CRP

• CXR = extensive patchy infiltrates in RLL and entire left lung

• DAP d/c

• Corticosteroids

Improved within 24 h

Patel [14] (2014)

61/F

Osteomyelitis

NR

1

• Dry cough

• Dyspnea requiring MV

• BAL = 30%

• Peripheral eosinophilia

• CT = bilateral pleural effusion, diffuse bilateral patchy infiltrate

• DAP d/c

• Corticosteroids

Improved within 72 h

Phillips [15] 2014)

48/M

Osteomyelitis

6

3

• Fever

• Dyspnea requiring MV

• BAL = 17%

• Peripheral eosinophilia

• CXR = patchy bilateral airspace opacities

• DAP d/c

• Corticosteroids

• Improved

28/M

Osteomyelitis

6

4

• Dyspnea requiring MV

• Chest pain, light-headedness

• BAL = 74%

• Peripheral eosinophilia

• CT = diffuse multi-lobar infiltrates

• DAP d/c

• Corticosteroids

Resolution within 1 week

Yamamoto [16] (2014)

82/M

MRSA bacteremia

10

2

• Low grade fever

• Hypoxia

• CT = bilateral ground glass opacities

• Sputum negative for eosinophils

• DAP d/c

Improved

Yusuf [17] (2014)

64/M

Prosthetic joint infection

10

4

• Fever

• BAL = 47%

• Peripheral eosinophilia

• Elevated CRP

• CT = diffuse bilateral ground-glass opacities

• DAP d/c

Improved within 24 h

61/M

Prosthetic joint infection

10

2

• Fever

• Dyspnea requiring MV

• BAL = 3%

• Peripheral eosinophilia

• Elevated CRP

• CT = ground-glass consolidation, bilateral pleural effusion

• DAP d/c

Improved within 24 h

Chiu [18] (2015)

77/M

Osteomyelitis

6

6

• Pleuritic chest pain

• Cough, dyspnea requiring O₂

• BAL = 18%

• Elevated CRP

• CXR = diffuse bilateral airspace disease

• DAP was d/c 1 day before symptoms

• Corticosteroids

Improved within 60 h

74/F

Infected hip reconstruction

6

1^b

• Fever

• Dyspnea requiring O₂

• CXR – bilateral airspace disease

• DAP d/c

• Corticosteroids

Improved within 24 h

Hagiya [19] (2015)

34/M

Endocarditis

10

1

• Cough with mild hypoxemia

• Peripheral eosinophilia

• Elevated CRP

• CT = consolidation in peripheral field of right upper lobe

• DAP d/c

Resolved within 6 weeks

Hatipoglu [20] (2015)

67/F

MRSA diabetic foot ulcer

NR^c

3.3

• Cough, dyspnea requiring BPAP

• Fever, fatigue, decreased appetite

• Peripheral eosinophilia

• Elevated CRP

• CT = right lobe infiltration

• DAP d/c

• Inhaled corticosteroids

Improved within 72 h

Roux [21] (2015)

67/M

MSSA prosthetic hip infection

6

2.4

• Dry cough, hypoxemia

• BAL = 10%

• Peripheral eosinophilia

• CT = diffuse alveolar and interstitial opacities

• DAP d/c

• Corticosteroids

Improved within 96 h

Wojtaszczyk [22] (2015)

76/M

Septic arthritis and pacemaker vegetation

NR

2

• Dyspnea requiring O₂, cough

• Fever, fatigue

• BAL = 58%

• Elevated CRP

• CT = bilateral ground glass opacity, patchy consolidation

• DAP d/c

• Corticosteroids

Resolved within 72 h

Akcaer [23] (2016)

60/M

MSSA post-amputation abscess

5

3.4

• Tachypnea, hypoxia requiring O₂

• Peripheral eosinophilia

• Elevated CRP

• Elevated ESR

• HRCT = right pleural effusion, bilateral tree-in-bud pattern, bilateral scattered ground-glass opacities

• DAP d/c

Resolved within 72 h