Atypical Pneumonia and Late Drug Allergy due to Antibiotics

Introduction: Atypical pneumonia is a bacterial infection affecting lower respiratory tract. It’s also called Walking pneumonia because it’s usually not as severe as other types. It might just feel like a common cold and usually underdiagnosed or underrecognized. We presented atypical pneumonia and late drug allergy reaction during therapy
 

Case Presentation: Sixty four year old female was admitted to our policlinic with a complaint of cough, sore throat and hoarness. Her physical examination was normal except for pharyngeal erythema. Upper respiratory tract infection was thought and amoxicillin/clavulanate was started. After five days, the patient was developed chest pain and dry cough. The chest x-ray shows pleuropneumonia in the right lung effecting pleura and middle lobe in the lower lung zone, the left lung has no pathology. Routine blood and urine tests were all normal. Sputum was negative for acid fast bacillus. PPD was 17 mm with two BCG scar. Non-specific culture was’nt performed because of the patient has used antibiotic. Atypical pneumonia was suspected. The treatment regimen was changed to intravenous cephalosporin and quinolone. After three days, the treatment continued with the same oral group antibiotics. Maculo papule rash started on the patient’s hand and till on the sixth day of the treatment, the rush spread to the whole body on the seventh day. Itching, vertigo and taste disorder were also started. Late drug allergy was diagnosed. Whole drugs were stopped, dexamethasone along with fexadyn hydrochloride treatment was started. The skin eruption and symptoms decreased in five days.Then this drugs were stopped. Fifteen days later, the patient’s chest x-ray was showed significant resolution. The patient denied allergic drug tests.
 

Conclusion: Cephalosporin and quinolone antibiotics were potent drug at pneumonia treatment. Serious drug side effects sometimes were observed during course of treatment.