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Case Reports
. 2024 Jul 17;16(7):e64708.
doi: 10.7759/cureus.64708. eCollection 2024 Jul.

Drug-Induced Acute Eosinophilic Pneumonia With Pneumomediastinum: An Unusual Presentation

Vasu Agarwal  1 , Sidhaant Nangia  1 , Shaily Prasenan  1 , Siri Vineeth A Ganta  2
Affiliations
Case Reports

Drug-Induced Acute Eosinophilic Pneumonia With Pneumomediastinum: An Unusual Presentation

Vasu Agarwal et al. Cureus. .

Abstract

A 27-year-old female, with no significant past medical history, presented to the casualty department with a two-week history of progressive dyspnea, cough, and fever. She reported that she had recently started taking a non-conventional alternative medication for her irregular menstrual cycles. Chest radiography demonstrated bilateral alveolar opacities, and computed tomography (CT) of the chest revealed bilateral ground-glass opacities and pneumomediastinum. Laboratory testing showed peripheral blood eosinophilia, and bronchoscopy with bronchoalveolar lavage confirmed an elevated eosinophil count. Based on the clinical presentation, radiographic and laboratory findings, and exclusion of other etiologies, a diagnosis of drug-induced eosinophilic lung disease with pneumomediastinum was made. The alternative non-conventional drug was immediately discontinued and the patient was treated with systemic corticosteroids, leading to a rapid improvement in her symptoms and radiographic abnormalities. A repeat CT of the chest after 15 days revealed significant resolution of the ground-glass opacities and complete resolution of pneumomediastinum. This case highlights the importance of thorough medication history and vigilance for potential adverse effects of non-conventional treatments.

Keywords: bronchial asthma exacerbation; complementary alternative medicine; drug induced eosinophilic pneumonia; hypersensitive reaction; pneumomediastinum.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Plain chest radiograph with no apparent abnormalities
Figure 2
Figure 2. High-resolution computed tomography (HRCT) thorax with ground-glass opacities in the anterior and medial basal segments of the right lower lobe (green arrow) and the anteromedial segment of the left lower lobe (blue arrow)
Figure 3
Figure 3. High-resolution computed tomography (HRCT) thorax with pneumomediastinum in the neck (yellow arrow)
Figure 4
Figure 4. High-resolution computed tomography (HRCT) thorax showing a resolution of ground-glass opacities in the right lung parenchyma (pink arrow) and left lung parenchyma (green arrow)
See this image and copyright information in PMC

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