Severe respiratory failure secondary to drug-induced pneumonia associated with Saireito administration: a case report

Abstract

Severe drug-induced pneumonia following Chinese herbal medicine administration is uncommon. Discontinuing the drug often leads to spontaneous recovery; thus, ventilatory management is usually unnecessary. In this report, we describe a case of drug-induced pneumonia attributable to Saireito administration, which necessitated ventilatory management. An 82-year-old man presented to our hospital with fever and dyspnea. He had a 2-month history of Saireito use for sudden onset of sensorineural hearing loss. He developed dyspnea on exertion 10 days before presentation and visited his local physician who referred the patient to our hospital for emergency management of hypoxemia. Hypoxemia progressed, and the patient required ventilatory support. Based on the patient's history and various tests, we suspected drug-induced pneumonia caused by Saireito and initiated steroid therapy. Based on the clinical course and treatment response, the patient was diagnosed with drug-induced pneumonia attributable to Saireito. Drug-induced pneumonia may rarely lead to severe respiratory failure. Drug-induced pneumonia should be considered in the differential diagnosis of patients with severe respiratory failure.