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.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Infection and Chemotherapy
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Nontuberculous mycobacterial lung disease prevalence at four integrated health care delivery systems.Am J Respir Crit Care Med. 2010; 182: 970-976https://doi.org/10.1164/rccm.201002-0310OC
- Epidemiology of pulmonary nontuberculous mycobacterial disease.Japan. Emerg Infect Dis. 2016; 22: 1116-1117https://doi.org/10.3201/eid2206.151086
- A laboratory-based analysis of nontuberculous mycobacterial lung disease in Japan from 2012 to 2013.Ann Am Thorac Soc. 2017; 14: 49-56https://doi.org/10.1513/AnnalsATS.201607-573OC
- Amikacin liposome inhalation suspension for treatment-refractory lung disease caused by Mycobacterium avium complex (CONVERT) a prospective, open-label, randomized study.Am J Respir Crit Care Med. 2018; 198: 1559-1569https://doi.org/10.1164/rccm.201807-1318OC
- Safety and outcomes of amikacin liposome inhalation suspension for Mycobacterium abscessus pulmonary disease.Chest. 2022; 162: 76-81https://doi.org/10.1016/j.chest.2022.01.015
- Treatment of nontuberculous mycobacterial pulmonary disease: an official ats/ers/escmid/idsa clinical practice guideline.Clin Infect Dis. 2020; 71: E1-E36https://doi.org/10.1093/cid/ciaa241
- Clinical management of respiratory adverse events associated with amikacin liposome inhalation suspension: results from a patient survey.Open Forum Infect Dis. 2020; 7: OFAA079https://doi.org/10.1093/OFID/OFAA079
- Early-phase adverse effects and management of liposomal amikacin inhalation for refractory Mycobacterium avium complex lung disease in real-world settings.Infect Drug Resist. 2022; 15: 4001-4011https://doi.org/10.2147/IDR.S373783
- Inhaled liposomal antimicrobial delivery in lung infections.Drugs. 2020; 80: 1309-1318https://doi.org/10.1007/s40265-020-01359-z
- Liposomal amikacin inhalation suspension-induced pneumonitis.Intern Med. 2022; 61: 2547-2549https://doi.org/10.2169/internalmedicine.8796-21
- Lipoid pneumonia: an overview.Expet Rev Respir Med. 2010; 4: 799-807https://doi.org/10.1586/ers.10.74
Published online: April 24, 2023
Accepted: April 19, 2023
Received in revised form: March 30, 2023
Received: December 13, 2022
Publication stageIn Press Corrected Proof
© 2023 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.