2017 Volume 127 Issue 3 Pages 463-468
A variety of visceral involvements develop throughout the course of drug-induced hypersensitivity syndrome (DIHS). Pneumonia during the course of DIHS has been retrospectively investigated in recent Japanese case reports. The pneumonia was classified into two groups: early onset pneumonia that appeared within 2 weeks after development of DIHS, and late onset pneumonia that appeared more than 5 weeks after the onset. In the early onset group, pneumonia developed before treatment for DIHS. No infectious agents were detected and favorable outcomes were achieved with corticosteroid. On the other hand, in the late onset group, the patients were older, and infectious agents such as cytomegalovirus and Pneumocystis jirovecii, were frequenthy detected. Pneumocystis jirovecii pneumonia (PCP) often resulted in poor outcomes. The results suggest that PCP could be one of the poor prognostic factors for DIHS. A further accumulation of case reports and laboratory analyses around the development of PCP in DIHS patients, is needed. In addition, based on the pathomechanism of DIHS, the prophylactic administration of antimicrobial agents and appropriate treatment for PCP is advised.
