Acute Eosinophilic Pneumonia Among US Military Personnel Deployed in or Near Iraq

Abstract

OSINOPHILIC LUNG DISEASES comprise a variety of processes ranging from Churg-Strauss syndrome to drug reactions. 1 Acute eosinophilic pneumonia (AEP) is a recently described syndrome characterized by a febrile illness, diffuse infiltrates on chest radiograph, and pulmonary eosinophilia. 2 Generally, patients with AEP present with respiratory failure requiring mechanical ventilation. 3,4 Clinicians may initially confuse AEP with severe communityacquired pneumonia, acute respiratory distress syndrome (ARDS), or both. It is unclear if less-severe forms of AEP exist. Histopathologically, lung biopsies in patients with AEP reveal both acute and organizing diffuse alveolar damage with eosinophils filling both the alveolar and interstitial spaces. 5 Peripheral eosinophilia may be noted in AEP; however, it is often absent at the time of presentation, which complicates efforts at diagnosis and case identification and suggests that the initial insult in this disease occurs in the lungs. Although a num

Physical comorbidities of post‐traumatic stress disorder in Australian Vietnam War veterans

“…Current literature suggests that the most common respiratory exposure of concern is smoke associated with burning waste and/or oil fires and sand/dust [3,86,160,166]. However, our finding that 'dust storms' and 'diesel exhaust' were the most commonly reported respiratory exposures differs from the literature, and may be a reflection of different defence forces operating in different locations.…”

“…Iraq or Afghanistan) rather than generally to the MEAO. [3], acute eosinophilic pneumonia [160], and other non-specific respiratory symptoms [66, 84,86,155]. Additionally, some of the most common environmental concerns identified by MEAO veterans have included smoke from oil fires, pollutants from incinerated waste, and particulate matter from sand and/or dust [3,86,160].…”

Eosinofilia pulmonar

“…Smoking is strongly correlated with AEP, especially in individuals who have recently started smoking. (5,31) Massive inhalation of moldy hay (i.e., Aspergillus spp. mold) is another risk factor.…”

“…Recently, 18 cases of AEP were described among American soldiers deployed in Iraq, all of whom were smokers-14 were recent-onset smokers, and 17 had been exposed to desert sandstorms. (5) Drug exposure is currently a major cause of pulmonary eosinophilia. (6)(7)(8) A long list of drugs that cause pulmonary infiltrates with eosinophilia is available on "The Drug-Induced Lung Diseases" site (www.pneumotox.com).…”

Clinical laboratory testing for smoking toxicity: implications for early identification of respiratory diseases

“…24 The implication is that eosinophilic pneumonia is associated with cigarette smoking. [31][32][33][34] Indeed, it is very plausible that BAL may be useful for screening early or subclinical respiratory diseases among cigarette smokers. 35 Respiratory diseases are also associated with rheological properties of blood, which in turn constitute subclinical vasculopathy with known laboratory biomarkers and cigarette smoke.…”