ミノサイクリンによる薬物性肺炎および胸膜炎の1例

Minocycline-induced Pneumonia and Pleurisy : A case report

　患者は52歳，男性．扁桃周囲膿瘍の診断にて耳鼻咽喉科入院，切開排膿後抗生物質にて治療，退院時ミノサイクリン（MINO）200mg／日が処方された．服用約11日後より高熱が出現，扁桃周囲膿瘍の再発は認めず精査のため同科へ再入院となった．入院後MINO 200mg／日が経静脈的に再投与され，発熱は増悪，咳漱，喀痰，呼吸困難を伴い胸部X線にて間質性陰影，多量の両側胸水が出現した．投与中止に伴い症状，胸部X線所見は速やかに改善し，臨床経過よりMINOによる薬物性肺炎，胸膜炎と診断した．リンパ球刺激試験は陰性であった．テトラサイクリン系をはじめ抗生物質による薬物性肺炎の報告が増えている．MINOによる肺炎に胸膜炎を合併した症例は本邦2例目と思われる．

A 52-year-old male was admitted to our hospital with a diagnosis of peritonsillar abscess. The peritonsil-lar abscess was drained and antibiotics were adminis-tered. At the time of discharge from our hospital the patient was given minocycline, 200mg/day, to be taken orally. After taking minocycline for approximately 11 days after discharge, the patient returned with a high fever when antibiotics other than minocycline were administered. The patient was re-admitted with the chief complaint of fever and sore throat. This time, minocycline was administered intravenously.