Abstract
This report is presented of two cases of drug induced pulmonary disease. One case is a pulmonary infiltrate with eosinophilia (P. I. E.) syndrome due to hydrochlorothiazide and the other case is an interstitial pneumonitis due to streptomycin (SM).
Case 1. A 73-years-old male was came to our hospital because of elevation of temperature, coughing and expectoration in December, 1977. Finding of laboratory examination showed no significant abnormality except for ESR 64mm/h, CRP+6, WBC 12, 600/cmm, 37% eosinophils and IgE 3, 937u/ml. Chest X-ray revealed diffuse reticulo-nodular shadow in both lung field. After hydrochlorothiazide was discontinued, all of the above abnormalities turned to be normal. This case was considered to be a P. I. E. syndrome due to possible allergic reaction of hydrochlorothiazide.
Case 2. A 71-years-old male was admitted with active pulmonary tuberculosis and treated with SM (lg/day, 3/week), isoniazid and ethambutol since October, 1975. Three months later, chest X-ray showed considerable improvement. In March, 1976, after 55 injections of SM, the patient's temperature rose up to 38.1°C and there after, whenever SM was injected. The patient complained of increasing dyspnea on exertion since that time. Then chest X-ray revealed diffuse patchy shadow although laboratory examination demonstrated no abnormality. After injection of SM was discontinued, chest X-ray showed remarkable improvement and the patient's dyspnea on exertion subsided. This case was considered to be an interstitial pneumonitis due to SM.
