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Background  Drug-induced pneumonia (d-pneumonia) and bacterial pneumonia (b-pneumonia) are often difficult to differentiate; therefore, this study examined the possibility of differentiating them using serum biomarkers.    Methods  The study included 22 and 16 patients diagnosed with b- and d-pneumonia, respectively, at our institution or affiliated institutions. For d-pneumonia, the causative drug was minocycline hydrochloride in four patients, gefitinib in two patients, nivolumab in two patients, pembrolizumab in two patients, sulfasalazine in two patients, loxoprofen in one patient, Bouiougitou in one patient, edoxaban tosilate hydrate in one patient, and abemaciclib in one patient. White blood cell (WBC), C-reactive protein (CRP), Krebs von den Lungen-6 (KL-6), surfactant protein (SP)-D, and SP-A levels were measured in each patient and compared between the groups.    Results  Significant differences were noted in the WBC and SP-D levels between the two groups ( P  < 0.05,  P  < 0.001), but not in the CRP, KL-6, or SP-A levels.    Conclusion  The study results suggest that SP-D is a useful marker for differentiating b-pneumonia and d-pneumonia.

Surfactant protein D: a useful marker for differentiation of drug-induced pneumonia and bacterial pneumonia