Pulmonary Infiltrates with Eosinophilia

JI etracycline continues to be one of the most frequently used antibiotics. It is often prescribed for the treatment of acute bronchitis, urinary tract infections and refractory facial acne. Longstanding familiarity with the drug has established its relative safety when administered orally, even for prolonged periods of time, as in the treatment of acne.1 Current reviews have summarized the adverse reactions common to the tetracycline family2 and its derivatives.3’4 To date, no pulmonary side effects related to use of tetracycline have been reported, except for those associated with presumed tetracycline-induced systemic lupus erythen-iatosis.5 We have recently seen two patients in whom the development of pulmonary infiltrates and eosinophilia was associated with the concurrent use of tetracycline drugs. We propose that tetracycline may be another causative agent associated with the syndrome of pulmonary infiltrates with eosinophilia (PIE).