Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2022; 10(27): 9936-9944
Published online Sep 26, 2022. doi: 10.12998/wjcc.v10.i27.9936
Drug-induced lung injury caused by acetaminophen in a Japanese woman: A case report
Masayoshi Fujii, Tsuneaki Kenzaka
Masayoshi Fujii, Department of Internal Medicine, Toyooka Public Hospital, Toyooka 668-8501, Japan
Masayoshi Fujii, Tsuneaki Kenzaka, Department of Internal Medicine, Hyogo Prefectural Tamba Medical Center, Tamba 669-3495, Japan
Tsuneaki Kenzaka, Division of Community Medicine and Career Development, Kobe University Graduate School of Medicine, Kobe 652-0032, Japan
Author contributions: Fujii M managed the case and revised and corrected the manuscript; Kenzaka T assisted with redaction, correction, and reconstruction of the manuscript; all authors read and approved the final manuscript.
Informed consent statement: The patient provided written informed consent for the publication of this case report and accompanying images. A copy of the consent form is available for review by the editor of this journal.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: All authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Tsuneaki Kenzaka, MD, PhD, Professor, Division of Community Medicine and Career Development, Kobe University Graduate School of Medicine, 2-1-5 Arata-cho, Hyogo-ku, Kobe 652-0032, Japan.
Received: May 21, 2022
Peer-review started: May 21, 2022
First decision: June 27, 2022
Revised: July 2, 2022
Accepted: August 11, 2022
Article in press: August 11, 2022
Published online: September 26, 2022

All drugs have the potential to cause drug-induced lung injury both during and after drug administration. Acetaminophen has been reported to cause drug-induced lung injury, although this is extremely rare. Herein, we present an extremely rare case of acetaminophen-induced pneumonia.


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).


Even common drugs such as over-the-counter drugs can cause drug-induced lung damage.

Keywords: Acetaminophen, Computed tomography, Pneumonia, Fever, Tick bite, Case report

Core Tip: We present an extremely rare case of acetaminophen-induced lung injury. Even common drugs, including over-the-counter drugs, can cause lung injury, warranting consideration when evaluating emergent lung disease.