Chronic Eosinophilic Pneumonia: a Case Report

Abstract

Chronic eosinophilic pneumonia (CEP) is a rare idiopathic interstitial lung disease, predominantly observed in females. Eosinophilia is present in most cases, and alveolar eosinophilia is a diagnostic criterion in more than 40% of bronchoalveolar lavage (BAL) samples. The current study reported a 27-year-old male patient, non-smoker, with a history of uncontrolled asthma, presented to the emergency room with a complaint of cough, fever, and moderate dyspnea. A 30% eosinophilia was reported in his peripheral blood sample. A chest-X ray examination showed an upper and middle lobe consolidation, especially in the left lung. Broad-spectrum antibiotics were then started with a presumptive diagnosis of pneumonia, but no improvements were evident. The chest computed tomography scan showed air space opacities with septal thickening and predominant involvement of upper and middle lobes. Flexible bronchoscopy was performed, and the BAL sample analysis showed eosinophil infiltration, while negative culture. No parasites were identified. Transbronchial biopsies demonstrated eosinophil accumulation in alveoli and interstitium.

Conclusion: Early recognition, diagnosis, and prompt treatment with corticosteroids are the main therapeutic approaches to CEP.

Keywords: Chronic Eosinophilic Pneumonia; Eosinophilia; Interstitial Lung Disease; Pneumonia.

Figure 1.

CT scan of the chest demonstrates areas with ground glass opacities

Figure 2.

Chest radiographs of the patient before starting corticosteroid therapy (a) and 72 hours after starting medication (b) revealing dramatic regression of interstitial opacities in response to the treatment.