{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T02:46:15Z","timestamp":1761965175400},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T00:00:00Z","timestamp":1582070400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T00:00:00Z","timestamp":1582070400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["surg case rep"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Acute eosinophilic pneumonia (AEP) is a rare idiopathic lung disease characterized by pulmonary eosinophilia. The epidemiology of AEP remains understudied; however, past reports have reported that AEP can be caused by an allergic reaction to medications, such as antibiotics or inhaled antigens, such as tobacco smoke. AEP usually occurs bilaterally. However, we encountered an unusual case of antibiotic-induced eosinophilic pneumonia showing unilateral consolidation just on the operative side, which was initially diagnosed as postoperative bacterial pneumonia and treated with antibiotic therapy. The prescribed antibiotics paradoxically provoked AEP and worsened the patient\u2019s condition. Here, we report this antibiotic-induced AEP case showing unilateral consolidation only on the operative side which could be triggered by surgery for primary lung cancer.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>A 74-year-old man underwent right upper lobectomy for lung adenocarcinoma. On postoperative day (POD) 9, an interstitial shadow appeared in the right lower lung field of the chest radiographs, along with a fever of 38.5\u2009\u00b0C, dyspnea needing oxygen supplementation, and increased purulent sputum production, suggesting postoperative bacterial pneumonia. Despite administration of the broad-spectrum antibiotic, meropenem, the fever did not improve, and pulmonary opacity gradually worsened. Blood analysis showed increased peripheral eosinophils at 1182\/mm<jats:sup>3<\/jats:sup>. The meropenem treatment was discontinued and bronchoscopy was performed for further evaluation, and the bronchoalveolar lavage fluid assessment showed a remarkable increase in the eosinophil population (51%). The drug lymphocyte stimulation test (DLST) for meropenem was positive. We diagnosed the patient with antibiotic-induced unilateral AEP, after which corticosteroid treatment was initiated. The patient subsequently improved and the infiltration in the right lower lung field completely disappeared. The patient was discharged on POD 43 without oxygen supplementation and is doing well without tumor recurrence 16\u2009months after the surgery.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Unilateral drug-induced AEP is rare. Nonetheless, it should be recognized as a differential diagnosis of postoperative pneumonia even in cases of a unilateral radiographic infiltration, because the lung operation itself could trigger this type of AEP.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s40792-020-00803-2","type":"journal-article","created":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T12:03:52Z","timestamp":1582113832000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Unilateral antibiotic-induced acute eosinophilic pneumonia on the operative side after surgery for primary lung cancer: a case report"],"prefix":"10.1186","volume":"6","author":[{"given":"Yasufumi","family":"Goda","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsuyoshi","family":"Shoji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiromichi","family":"Katakura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,2,19]]},"reference":[{"key":"803_CR1","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1056\/NEJM198908313210903","volume":"321","author":"JN Allen","year":"1989","unstructured":"Allen JN, Pacht ER, Gadek JE, Davis WB. Acute eosinophilic pneumonia as a reversible cause of noninfectious respiratory failure. N Engl J Med. 1989;321:569\u201374.","journal-title":"N Engl J Med"},{"key":"803_CR2","doi-asserted-by":"publisher","first-page":"535e56","DOI":"10.1016\/j.ccm.2016.04.015","volume":"37","author":"V Cottin","year":"2016","unstructured":"Cottin V. Eosinophilic lung diseases. Clin Chest Med. 2016;37:535e56.","journal-title":"Clin Chest Med"},{"key":"803_CR3","doi-asserted-by":"crossref","unstructured":"Yuzo Suzuki Y, Suda T. Eosinophilic pneumonia: a review of the previous literature, cases, diagnosis, and management. Allergol Int. 2019.","DOI":"10.1016\/j.alit.2019.05.006"},{"key":"803_CR4","doi-asserted-by":"publisher","first-page":"462e7","DOI":"10.1016\/j.ejrad.2007.04.012","volume":"65","author":"T Daimon","year":"2008","unstructured":"Daimon T, Johkoh T, Sumikawa H, Honda O, Fujimoto K, Koga T, et al. Acute eosinophilic pneumonia: thin-section CT findings in 29 patients. Eur J Radiol. 2008;65:462e7.","journal-title":"Eur J Radiol"},{"key":"803_CR5","doi-asserted-by":"publisher","first-page":"670","DOI":"10.1016\/j.jtcvs.2017.09.089","volume":"155","author":"KA Kirkwood","year":"2018","unstructured":"Kirkwood KA, Gulack BC, Iribarne A, et al. A multi-institutional cohort study confirming the risk of Clostridium difficile infection associated with prolonged antibiotic prophylaxis. J Thoracic Cardiovasc Surg. 2018;155:670\u20138.","journal-title":"J Thoracic Cardiovasc Surg"},{"issue":"6","key":"803_CR6","doi-asserted-by":"publisher","first-page":"728","DOI":"10.1164\/rccm.201710-1967CI","volume":"197","author":"F De Giacomi","year":"2018","unstructured":"De Giacomi F, Vassallo R, Yi ES, Ryu JH. Acute eosinophilic pneumonia. Cause, diagnosis, and management. Am J Respir Crit Care Med. 2018;197(6):728\u201336.","journal-title":"Am J Respir Crit Care Med"},{"key":"803_CR7","doi-asserted-by":"publisher","first-page":"1125","DOI":"10.1164\/ajrccm.165.8.2106110","volume":"165","author":"E Miyazaki","year":"2002","unstructured":"Miyazaki E, Nureki S, Fukami T, Shigenaga T, Ando M, Ito K, et al. Elevated levels of thymus- and activation-regulated chemokine in bronchoalveolar lavage fluid from patients with eosinophilic pneumonia. Am J Respir Crit Care Med. 2002;165:1125\u201331.","journal-title":"Am J Respir Crit Care Med"},{"key":"803_CR8","doi-asserted-by":"publisher","first-page":"S3","DOI":"10.1016\/S0020-1383(07)70005-0","volume":"37","author":"PV Giannoudis","year":"2006","unstructured":"Giannoudis PV, Dinopoulos H, et al. Surgical stress response. Injury. 2006;37:S3\u20139.","journal-title":"Injury."},{"issue":"10","key":"803_CR9","first-page":"799","volume":"45","author":"T Izumo","year":"2007","unstructured":"Izumo T, Kondo M, Mae M, et al. Case of loxoprofen sodium-induced eosinophilic pneumonia that occurred ipsilaterally after VATS lobectomy for lung cancer. Nihon Kokyuki Gakkai Zasshi. 2007 Oct;45(10):799\u2013803.","journal-title":"Nihon Kokyuki Gakkai Zasshi"},{"issue":"4","key":"803_CR10","doi-asserted-by":"publisher","first-page":"471","DOI":"10.2995\/jacsurg.28.471","volume":"28","author":"Y Masuda","year":"2014","unstructured":"Masuda Y, Yamada T, et al. A case of unilateral eosinophilic pneumonia following lung resection for lung cancer caused by fibrin sealant. J Jpn Assoc Chest Surg. 2014;28(4):471\u20136.","journal-title":"J Jpn Assoc Chest Surg"}],"container-title":["Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-020-00803-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s40792-020-00803-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-020-00803-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,18]],"date-time":"2021-02-18T08:31:25Z","timestamp":1613637085000},"score":1,"resource":{"primary":{"URL":"https:\/\/surgicalcasereports.springeropen.com\/articles\/10.1186\/s40792-020-00803-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,19]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["803"],"URL":"https:\/\/doi.org\/10.1186\/s40792-020-00803-2","relation":{},"ISSN":["2198-7793"],"issn-type":[{"value":"2198-7793","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,19]]},"assertion":[{"value":"24 December 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 February 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 February 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient prior to publication of this case report and any accompanying images.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"40"}}