minocycline and Lung-Diseases--Interstitial

Topics: Amiodarone; Animals; Anti-Arrhythmia Agents; Anti-Bacterial Agents; Antibiotics, Antineoplastic; Antirheumatic Agents; Contrast Media; Drugs, Chinese Herbal; Gefitinib; Granulocyte Colony-Stimulating Factor; Humans; Interferons; Iodine Radioisotopes; Lung Diseases, Interstitial; Minocycline; Paclitaxel; Quinazolines

A 28-year-old patient is described who presented with progressive dyspnoea and jaundice due to interstitial pneumonia and hepatitis. The most likely cause is a drug-related reaction to minocycline. We discuss the different kinds of drug-related reactions that are most likely involved.

Topics: Acne Vulgaris; Adult; Anti-Bacterial Agents; Chemical and Drug Induced Liver Injury; Dyspnea; Humans; Lung Diseases, Interstitial; Male; Minocycline; Radiography, Thoracic

We report a case of bulla infection caused by Mycobacterium fortuitum. The patient was a 66 year-old female associated with interstitial pneumonitis. The chest X-ray film showed cavities with thick walls and niveau formation, which initially suggested pulmonary abscesses. The chest CT scan showed infiltrative shadows surrounding multiple bullae. Smears and cultures of the sputum were repeatedly positive for mycobacteria, which was identified to be M. fortuitum. By chemotherapy with imipenem/cilastatin sodium, clarithromycin, levofloxacin, and minocycline on the basis of susceptibility test, sputum converted to negative within 2 months, abnormal shadows on the roentgenogram and laboratory data showed improvement. There are no signs of recurrence after completion of the treatment for 12 months.

Topics: Aged; Blister; Cilastatin; Cilastatin, Imipenem Drug Combination; Clarithromycin; Drug Combinations; Drug Therapy, Combination; Female; Humans; Imipenem; Levofloxacin; Lung Diseases, Interstitial; Minocycline; Mycobacterium fortuitum; Mycobacterium Infections, Nontuberculous; Ofloxacin; Pulmonary Emphysema

Minocycline has been identified as a pathogenic agent in drug-induced pneumonia. We report a new case.. A 38-year-old female asthmatic patient was given minocycline (100 mg/j) for facial acne. She was allergic to penicillin. Other treatments were theophylline, salbutamol and inhaled budesonide. Severe bilateral hypoxemia pneumonia developed with high eosinophil blood counts within a few days of treatment onset. The lung disease regressed with minocycline withdrawal.. This case is exceptional because the minocycline-induced lung disease continued to progress despite high-dose corticosteroids in this asthmatic patient.

Topics: Adult; Anti-Bacterial Agents; Asthma; Female; Humans; Lung Diseases, Interstitial; Minocycline

We identified eight patients (six women and two men) who had pulmonary infiltrates during treatment with minocycline hydrochloride between 1989 and 1992 in French referral centers for drug-induced pulmonary diseases. Clinical files, chest roentgenograms, computed tomographic scans, pulmonary function, and bronchoalveolar lavage data were reviewed. Minocycline treatment was given for acne (n = 4), genital infection (n = 3), and Lyme disease (n = 1). The duration of treatment averaged 13 +/- 5 days (mean +/- SE); the total dose, 2060 +/- 540 mg. Patients presented with dyspnea (n = 8), fever (n = 7), dry cough (n = 5), hemoptysis (n = 1), chest pain (n = 2), fatigue (n = 3), and rash (n = 3). Chest roentgenograms showed bilateral infiltrates in all cases. Pulmonary function was measured in five patients; four had airflow obstruction and two had mild restriction. Blood gas tests demonstrated hypoxemia in seven patients (58 +/- 3 mmHg). Seven patients had blood eosinophilia (1.76 +/- 0.2 x 10(9)/L). Bronchoalveolar lavage (performed in seven patients) showed an increased proportion of eosinophils (0.30 +/- 0.07). The Cd4+/CD8+ ratio was determined in four cases and was low in three. Transbronchial lung biopsy, performed in two patients, showed interstitial pneumonitis in both patients, with marked infiltration by eosinophils in one patient. The outcome was favorable in all patients. Because of severe symptoms, steroid therapy was required in three patients. Rechallenge was not attempted. We conclude that minocycline can induce the syndrome of pulmonary infiltrates and eosinophilia, that presenting symptoms may be severe and may culminate in transient respiratory failure, and that the disease has a favorable prognosis.

Topics: Adolescent; Adult; Eosinophilia; Female; Humans; Lung Diseases, Interstitial; Male; Middle Aged; Minocycline; Prognosis

A 64-year-old male was admitted to our hospital with dyspnea and high fever. The patient had a relative bradycardia and severe hypoxemia. Velcr rales were heard throughout the entire lung fields. Leucocytosis was absent. Chest X-ray showed bilateral diffuse reticular shadows. Corticosteroid pulse therapy and minocycline were introduced on the suspicion of either idiopathic interstitial pneumonia or Chlamydial pneumonia. Subsequently, his symptoms gradually improved. Although the patient had no history of exposure to birds, the titer of complement fixation test for Chlamydia was 1:32 during the acute illness. Microplate immunofluorescence antibody technique proved infection with Chlamydia pneumoniae. We consider this is a rare case of severe pneumonia caused by C. pneumoniae.

Topics: Antibodies, Bacterial; Chlamydia Infections; Chlamydophila pneumoniae; Drug Therapy, Combination; Fluorescent Antibody Technique; Humans; Lung Diseases, Interstitial; Male; Methylprednisolone; Middle Aged; Minocycline