Blood culture-negative prosthetic valve endocarditis and daptomycin-associated eosinophilic pneumonia: A case report

Abstract

Acute eosinophilic pneumonia is a rare but severe side effect of daptomycin, which has been recommended as empirical antimicrobial drug therapy for blood culture-negative prosthetic valve endocarditis. Here, we present a case of an 82-year-old man who developed fever, cough, and shortness of breath after 23-day treatment with daptomycin for prosthetic valve endocarditis. Bilateral ground-glass opacities were observed on computed tomography with peripheral eosinophilia of 640/μL (7%). Cessation of daptomycin and commencement of corticosteroid therapy improved his symptoms. This case highlights the importance of prompt diagnosis of acute eosinophilic pneumonia in endocarditis patients treated with daptomycin. <Learning objective: Acute eosinophilic pneumonia is a rare but severe side effect of daptomycin, which has been recommended as empirical antimicrobial drug therapy for blood culture-negative endocarditis. As an alternative to vancomycin for treatment of methicillin-resistant Staphylococcus aureus, the use of daptomycin for culture-negative endocarditis is increasing. Daptomycin-induced acute eosinophilic pneumonia requires withdrawal of daptomycin and commencement of oral prednisolone. Careful prescription of oral antibiotics is needed in febrile patients with prosthetic valves.>.

Keywords: Acute eosinophilic pneumonia; Culture negative endocarditis; Daptomycin; Prosthetic valve endocarditis; Steroid.