Assuntos
Falência Renal Crônica , Lúpus Eritematoso Sistêmico , Doenças Renais Policísticas/complicações , Prednisolona/administração & dosagem , Idoso , Feminino , Glucocorticoides/administração & dosagem , Humanos , Falência Renal Crônica/etiologia , Falência Renal Crônica/terapia , Transtornos de Início Tardio/diagnóstico , Transtornos de Início Tardio/tratamento farmacológico , Transtornos de Início Tardio/fisiopatologia , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Lúpus Eritematoso Sistêmico/fisiopatologia , Diálise Renal/métodos , Resultado do TratamentoRESUMO
INTRODUCTION: Although several studies did not demonstrate that daptomycin may cause significantly higher rates of pulmonary adverse effects when compared with vancomycin or penicillinase-resistant penicillins, there have been a few case reports of severe pulmonary complications associated with daptomycin administration. CASE PRESENTATION: A rare case of eosinophilic pneumonia occurring 10 days after daptomycin administration in a 78-year-old Caucasian man with possible infectious endocarditis is described. He developed new onset fever, up to 38.5°C, with bilateral pulmonary crackles on physical examination and with no signs of severe respiratory failure. A chest computed tomography-scan showed bilateral nodular consolidations with air bronchograms and pleural effusions. Immediate discontinuation of daptomycin was followed by vigorous improvement of clinical signs and symptoms with progressive resolution of pulmonary consolidations a month later. CONCLUSION: Physicians should be aware of this rare but serious complication during daptomycin treatment, and prompt discontinuation of the offending agent, with or without additional supportive treatment, must occur immediately.
RESUMO
Adult onset Still's disease (AOSD) is a well recognized clinical disorder characterized by a typical rash. However, there have been several atypical cutaneous findings reported in patients with AOSD. Cutaneous polyarteritis nodosa (PAN) is a necrotizing vasculitis of the small and medium sized arteries, distinguishing itself from systemic PAN by its restriction to the skin and to the neurological and osteo-muscular systems. We report the case of a patient with AOSD who is unique in having developed cutaneous polyarteritis nodosa (PAN) during the active phase of her disease. To the best of our knowledge, no previous cases of AOSD associated with a cutaneous variant of PAN have been reported.
