Drug-induced lung injury caused by acetaminophen in a Japanese woman: A case report

Abstract

BACKGROUND All drugs have the potential to cause drug-induced lung injury both during and after drug administration. Acetaminophen has been reported to cause druginduced lung injury, although this is extremely rare. Herein, we present an extremely rare case of acetaminophen-induced pneumonia. CASE SUMMARY A healthy 35-year-old Japanese woman visited a neighborhood clinic with complaints of fever and malaise following a tick bite. Her treatment included 1,500 mg acetaminophen (Caronal®) and subsequently minocycline (200 mg) and acetaminophen (2,000 mg; Caronal®) daily when her condition did not improve; the patient was eventually hospitalized. The patient’s chest computed tomography (CT) revealed consolidation and ground-glass opacities in the right middle and lower lobes. Minocycline was shifted to sulbactam/ampicillin. However, her fever did not improve during follow-up, and her chest CT revealed extensive ground-glass opacities in the right middle and lower lobes and thick infiltrative shadows in the bilateral basal areas. Drug-induced lung injury was suspected; hence, acetaminophen was discontinued. The fever resolved immediately, and inflammatory response and respiratory imaging findings improved. A drug-induced lymphocyte stimulation test was performed against acetaminophen (Caronal®), and significant proliferation of lymphocytes was noted only for acetaminophen (stimulation index, 2.1). CONCLUSION Even common drugs such as over-the-counter drugs can cause drug-induced lung damage.