Presentation
Fever, productive cough, shortness of breath for past two weeks. Unresponsive to antibiotic treatment. Asthmatic, smoker.
Patient Data
PA upright: Basal-predominant patchy alveolar opacities superimposed on reticular opacities.
Follow-up radiograph 2 days later, following steroid treatment
PA upright: Complete resolution of alveolar opacities, with the persistence of reticular opacities.
Case Discussion
The patient had been on empiric antibiotic treatment prescribed at the health maintenance clinic for a presumptive diagnosis of bacterial pneumonia.
Complete blood count on hospital admission was remarkable for eosinophilia (10,000/µL, with the normal range being 0-400/µL). The patient was treated with ceftriaxone, clarithromycin, and prednisone, with a complete resolution of symptoms within a single day.
The symptomatology, prononuced eosinophilia, chest radiograph findings, and prompt resolution of symptoms after treatment which involved steroids, all point to acute eosinophilic pneumonia.
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