Idiopathic chronic eosinophilic pneumonia: a differential diagnosis of lower respiratory tract infection

BMJ Case Rep. 2022 May 20;15(5):e244458. doi: 10.1136/bcr-2021-244458.

Abstract

A 43-year-old woman presented with a presumed lower respiratory tract infection, with symptoms of persistent cough, lethargy, fevers and night sweats. Initial general practitioner assessment revealed raised C reactive protein and a leucocytosis comprising both a neutrophilia and an eosinophilia. The patient was initially treated for bacterial pneumonia. Despite treatment, the patient's condition did not improve and hospital admission was arranged for further investigation. Initial physical examination was unremarkable. A chest X-ray revealed bilateral, symmetrical, peripheral consolidation with an upper zone predominance. Subsequently, endobronchial washings revealed abundant eosinophils. A diagnosis of idiopathic chronic eosinophilic pneumonia was made, and the patient responded well to oral corticosteroids with complete resolution of radiological appearances 1 month later.

Keywords: pneumonia (respiratory medicine); radiology; respiratory medicine; respiratory system.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Bronchoalveolar Lavage
  • Diagnosis, Differential
  • Female
  • Humans
  • Pulmonary Eosinophilia* / diagnostic imaging
  • Pulmonary Eosinophilia* / drug therapy
  • Respiratory Tract Infections* / diagnosis

Supplementary concepts

  • Carrington syndrome