ABSTRACT
A man in his mid-30s presented to the emergency department with a 1-week history of fatigue, loss of appetite, fever and productive (yellow) cough. This progressed to requiring admission to intensive care needing a oxygen therapy via high-flow nasal cannula for acute hypoxaemic respiratory failure. He had recently started vortioxetine for major depressive disorder, and his acute symptoms correlated with an increase in the dose of vortioxetine. For more than 20 years, rare but consistent reports of serotonergic medications have been implicated in eosinophilic pulmonary conditions. During this same period, serotonergic medications have become a mainstay solution for a wide range of depressive symptoms and disorders. This is the first report of an eosinophilic pneumonia-like syndrome occurring while consuming the novel serotonergic medication vortioxetine.
Subject(s)
Depressive Disorder, Major , Pulmonary Eosinophilia , Respiratory Insufficiency , Male , Humans , Vortioxetine/adverse effects , Depressive Disorder, Major/drug therapy , Depressive Disorder, Major/diagnosis , Pulmonary Eosinophilia/chemically induced , Pulmonary Eosinophilia/diagnosis , Pulmonary Eosinophilia/drug therapy , Syndrome , Respiratory Insufficiency/chemically induced , Respiratory Insufficiency/therapySubject(s)
COVID-19/complications , Lung/diagnostic imaging , Pulmonary Eosinophilia/diagnosis , Adrenal Cortex Hormones/therapeutic use , COVID-19/diagnosis , COVID-19 Nucleic Acid Testing , Cough/etiology , Fever/etiology , Humans , Male , Middle Aged , Myalgia/etiology , Pulmonary Eosinophilia/complications , Pulmonary Eosinophilia/drug therapy , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2 , Tomography, X-Ray ComputedABSTRACT
A 65-year-old woman who presented with a constellation of symptoms, including cough with haemoptysis, fever, chills and hypoxia along with weight loss, was found to have diffuse alveolar haemorrhage. After a myriad of investigations returned normal, an open lung biopsy was performed, which revealed the diagnosis to be subacute eosinophilic pneumonia. This is one of its kind of rare presentations where eosinophilic pneumonia presents as diffuse alveolar haemorrhage and has been reported only five times prior to this.