Acute eosinophilic pneumonia

Case contributed by Dr Abdallah Al Khateeb

Presentation

Cough, weight loss, and low grade fever.

Patient Data

Age: 30 years
Gender: Female
X-ray

Day 1

  • Bilateral air space opacities that are scattered throughout both lungs.
  • No pleural effusion.
  • Mediastinal shadow is unremarkable.
  • Bilateral areas of ground glass opacities and consolidations at the subpleural and peribronchial regions, more at the upper and middle zones.
  • Focal areas of peribronchial cuffing.
  • Minimal left side pleural effusion.
  • The differential diagnosis includes eosinophilic pneumonia, cryptogenic organizing pneumonia and aypical infection.
  • The work up included CBC with differential, which showed significant eosinophilia (12%), and bronchoalveolar lavage, which showed significant eosinophilia as well (45%). A negative Zeihl-Neelsen stain.
X-ray

Day 10

Follow-up x-ray after 10 days of systemic low dose corticosteroids shows interval resolution of the previously reported air space opacities in both lungs.

Case Discussion

The fact that this patient's clinical and radiographic findings showed significant improvement following corticosteroid therapy make acute eosinophilic pneumonia the most likely diagnosis.

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