Pneumonia eosinofilic in pediatrics, clinical cases

Rev Chil Pediatr. 2019 Dec;90(6):657-661. doi: 10.32641/rchped.v90i6.1057.
[Article in English, Spanish]

Abstract

Introduction: Eosinophilic Pneumonia (EP) is a very rare disorder in Pediatrics. It is characterized by the infiltra tion of eosinophils in the pulmonary and alveolar interstitium, and may be primary or secondary as well as present an acute or chronic progress.

Objective: to present 2 pediatric EP clinical cases which were diagnosed at the pediatric intensive care unit of Clinica Indisa in Santiago, Chile between 2014 and 2017.

Clinical cases: Two older infants, who were hospitalized due to respiratory failure with a diagnosis of viral pneumonia. Both have asthmatic mothers. Additionally, they both had febrile syn drome, persistent condensation images in the chest x-rays, and peripheral eosinophilia throughout the course of the disease. One of the infants required oxygen for more than one month, and there was no eosinophilia in the bronchoalveolar lavage (BAL). In this case, the diagnosis of EP was reached via pulmonary biopsy. The other infant required mechanic ventilation for 28 days, and was diagnosed due to eosinophilia greater than 25% in the bronchoalveolar lavage. Both patients had excellent res ponse to systemic corticosteroids.

Conclusion: After ruling out other causes, EP should be suspected in children with pneumonia diagnosis, and persistent symptoms that do not respond positively to treatment, especially if associated with peripheral eosinophilia. The diagnosis of EP in pediatrics is confirmed with eosinophilia greater than 20% in BAL and, in some cases, it is necessary to perform a lung biopsy.

Publication types

  • Case Reports

MeSH terms

  • Biopsy
  • Bronchoalveolar Lavage
  • Eosinophilia / complications
  • Humans
  • Infant
  • Lung / pathology
  • Male
  • Oxygen / therapeutic use
  • Pneumonia, Viral / diagnosis
  • Pulmonary Eosinophilia / diagnosis*
  • Pulmonary Eosinophilia / diagnostic imaging
  • Pulmonary Eosinophilia / pathology
  • Respiration, Artificial
  • Respiratory Insufficiency / etiology

Substances

  • Oxygen