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Inhaled liposomal antimicrobials are known to cause hypersensitivity pneumonitis. Amikacin liposome inhalation suspension (ALIS) is a promising novel antimicrobial agent against refractory Mycobacterium avium complex infections. The frequency of drug-induced lung injury caused by ALIS is relatively high. To date, no reports of ALIS-induced organizing pneumonia diagnosed by bronchoscopy are available. We report a case of a 74-year-old female patient presenting with non-tuberculous mycobacterial pulmonary disease (NTM-PD). She was treated with ALIS for refractory NTM-PD. Fifty-nine days after starting ALIS, the patient developed a cough, and her chest radiographs indicated deterioration. She was diagnosed with organizing pneumonia based on pathological findings of the lung tissues obtained by bronchoscopy. After switching from ALIS to amikacin infusion, her organizing pneumonia improved. It is difficult to distinguish between organizing pneumonia and an exacerbation of NTM-PD based on chest radiography alone. Therefore, it is essential to perform an active bronchoscopy for diagnosis. Copyright © 2023 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.

Citation

Daisuke Takao, Kazuaki Takeda, Takahiro Takazono, Mutsumi Ozasa, Yuya Ito, Nobuyuki Ashizawa, Tatsuro Hirayama, Naoki Iwanaga, Shinnosuke Takemoto, Shotaro Ide, Masato Tashiro, Naoki Hosogaya, Takashi Kido, Noriho Sakamoto, Yasushi Obase, Shinji Okano, Koichi Izumikawa, Katsunori Yanagihara, Hiroshi Mukae. A case of drug-induced organizing pneumonia caused by amikacin liposome inhalation suspension. Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy. 2023 Aug;29(8):806-808

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PMID: 37098378

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