CHRONIC EOSINOPHILIC PNEUMONIA. REPORT OF ONE CASE

Lavado broncoalveolar y derrame pleural con hipereosinofilia. Caso clínico y revisión de la literatura

Author
Fernández-Bussy, Sebastián; Section of neumologia intervencional, Clinica Alemana-Universidad del Desarrollo, Santiago. Chile

Campos, Felipe; Section of neumologia intervencional, Clinica Alemana-Universidad del Desarrollo, Santiago. Chile

Ogueta, Isabel; Interno de medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago. Chile

Labarca, Gonzalo; Pontificia Universidad Catolica de Chile

Cabello, Hernán; Departmento de Enfermedades respiratorias, Clinica Alemana-Universidad del Desarrollo, Santiago. Chile

Full text
http://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/view/4491
Abstract
Chronic eosinophilic pneumonia (CEP) is uncommon and predominantly seen in women. More than 6% of eosinophils in peripheral blood and more than 25% in bronchoalveolar lavage are diagnostic criteria. Secondary causes of hypereosinophilic pneumonia must be ruled out. We report a 72 years old non-smoker man presenting in the emergency room with a history of cough, fever, and moderate dyspnea. He was not taking any medication. A chest-X ray showed a left lower lobe (LLL) consolidation, and was started on broad-spectrum antibiotics with a presumptive diagnosis of pneumonia. There was no improvement after therapy. A chest CT scan showed increased LLL consolidation and new left upper lobe ground glass opacities as well as a moderate left pleural effusion. Flexible bronchoscopy was performed and bronchoalveolar lavage showed 95% eosinophils, and had negative cultures. No parasites were identified. Transbronchial biopsies demonstrated eosinophil accumulation in alveoli and interstitium and pleural fluid was composed by 85% eosinophils. With the diagnosis of CEP, systemic corticosteroids were used with favorable clinical and radiological response.
 
Chronic eosinophilic pneumonia (CEP) is uncommon and predominantly seen in women. More than 6% of eosinophils in peripheral blood and more than 25% in bronchoalveolar lavage are diagnostic criteria. Secondary causes of hypereosinophilic pneumonia must be ruled out. We report a 72 years old non-smoker man presenting in the emergency room with a history of cough, fever, and moderate dyspnea. He was not taking any medication. A chest-X ray showed a left lower lobe (LLL) consolidation, and was started on broad-spectrum antibiotics with a presumptive diagnosis of pneumonia. There was no improvement after therapy. A chest CT scan showed increased LLL consolidation and new left upper lobe ground glass opacities as well as a moderate left pleural effusion. Flexible bronchoscopy was performed and bronchoalveolar lavage showed 95% eosinophils, and had negative cultures. No parasites were identified. Transbronchial biopsies demonstrated eosinophil accumulation in alveoli and interstitium and pleural fluid was composed by 85% eosinophils. With the diagnosis of CEP, systemic corticosteroids were used with favorable clinical and radiological response.
 
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