Macrolide antibiotic-induced vasculitis (Churg-Strauss syndrome)

Laryngo- rhino- otologie
A DietzK Andrassy

Abstract

Macrolides are known to have relatively few side effects and are prescribed in cases of allergic reaction to penicillin. The new macrolides, for example Azithromycin and Roxithromycin, are increasingly preferred over erythromycin at the ear, nose, and throat out-patient department due to improved oral reabsorption (acid resistance), better penetration into tissue, prolonged half-life, extended antibacterial activity, modest side effects, and better pharmacokinetics. There are only few case reports concerning side effects of macrolides. We report on the appearance of a Churg Strauss-Syndrome (CSS) in a patient following intake of the macrolide antibiotic azithromycin and roxithromycin. A 50-year-old patient with asthma for three years presented with arthritis and mononeuritis multiplex. Laboratory and radiological investigations revealed eosinophilia (64%), eosinophilic infiltrations of bone marrow, raised IgE-level, and transient pulmonary infiltrates. THERAPY AND DEVELOPMENT: Intravenous steroid therapy was started and resulted in normalization of eosinophilia, IgE-level, and asthmatic symptoms. The neurologic deficits showed only a weak tendency for improvement. The diagnosis of CSS was established on the basis of clinical cr...Continue Reading

Citations

Mar 25, 2008·Therapeutics and Clinical Risk Management·Deanna L McDanel, Barbara A Muller
Apr 6, 2004·Clinics in Chest Medicine·James N Allen
Jul 9, 2002·Allergy·L RicheldiL M Fabbri
Dec 5, 2006·Current Opinion in Rheumatology·Christian PagnouxLoïc Guillevin
May 19, 2010·Expert Review of Clinical Immunology·Julia U HolleWolfgang L Gross
Jan 19, 2002·Current Rheumatology Reports·Marta Lucia Cuellar
Aug 10, 2001·The Journal of Allergy and Clinical Immunology·P F WellerA Trontell

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