An 18-Year-Old Woman With Fever, Diffuse Pulmonary Opacities, and Rapid Onset of Respiratory Failure

Vahid, Bobbak; Marik, Paul E.

doi:10.1378/chest.130.6.1938

Cited by 9 publications

(8 citation statements)

References 9 publications

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“…If a patient does not respond to corticosteroids and/or organ systems other than the lungs are involved [25,31], the diagnosis of AEP should be questioned and other eosinophilic syndromes and infections should be considered. The benefit of systemic corticosteroids is based on observational data that suggests corticosteroids rapidly reverse the hypoxemic respiratory failure of AEP [21,25,27,33]. Treatment may not be universally needed, however, as some cases resolve without corticosteroids [3,25].…”

Section: Discussionmentioning

confidence: 99%

“…Our recommended approach (Fig. 4) based on review of the literature [21,25,27,29,33] and our own experience is as follows: in mechanically ventilated patients we start with intravenous methylprednisolone (60-125 mg) every 6 h until weaned from mechanical ventilation and tolerating oral medications. If the patient does not require ventilator support at the time of diagnosis we prescribe oral prednisone (40-60 mg) daily until the patient's oxygen requirement resolves.…”

Section: Discussionmentioning

confidence: 99%

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Acute eosinophilic pneumonia in the deployed military setting

Sine

Hiles

Scoville

et al. 2018

Respiratory Medicine

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Based on our experience and literature review, we recommend adjustments to the diagnostic criteria which may increase consideration of this etiology for acute respiratory illnesses as well as provide clinical clues we have found particularly helpful. Similar to recent reports of initial peripheral eosinophilia correlating with less severe presentation we found that higher BAL eosinophilia correlated with less severe hypoxemia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Acute eosinophilic pneumonia in the deployed military setting

Sine

Hiles

Scoville

et al. 2018

Respiratory Medicine

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“…The BAL shows eosinophils > 25%. (79) Treatment of the patient with even a single dose of corticosteroids prior to biopsy can markedly reduce the number of eosinophils in the tissue and thereby complicate the diagnostic evaluation.…”

Section: Acute Eosinophilic Pneumoniamentioning

confidence: 99%

Padrões tomográficos das doenças intersticiais pulmonares difusas com correlação clínica e patológica

et al. 2008

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High-resolution computed tomography (HRCT) is the radiological imaging technique best suited to revealing changes in lung structure. Various HRCT findings, taken together, can represent typical patterns. These patterns, in conjunction with the anatomical distribution of findings and with clinical data, can narrow the differential diagnosis of diffuse interstitial lung disease and, in many cases, indicate the correct diagnosis with a high degree of accuracy. The most common HRCT patterns seen in cases of diffuse interstitial lung diseases are the nodular pattern, linear/reticular opacities, cystic lesions, ground-glass opacities and consolidations. This article reviews the correlations between HRCT patterns and pathologic findings, summarizing the most common causes, as well as detailing the methods of investigation employed in order to diagnose the most common types of chronic diffuse lung disease.Keywords: Lung diseases, interstitial/pathology; Tomography, X-Ray computed; Diagnostic techniques, respiratory system. ResumoA tomografia de alta resolução (TCAR) é a técnica de imagem radiológica que reflete mais de perto as alterações da estrutura pulmonar. Os vários achados tomográficos podem ser combinados para formar padrões típicos. Estes, conjuntamente com a distribuição anatômica dos achados, e com os dados clínicos, podem estreitar o diagnóstico das doenças intersticiais pulmonares difusas, e em vários casos sugerir o diagnóstico correto com alto grau de acurácia. Os padrões mais comuns das doenças intersticiais pulmonares difusas na TCAR são o nodular, linear e reticular, lesões císticas, opacidades em vidro fosco e consolidações. Este artigo revisa as correlações entre os padrões tomográficos na TCAR e os achados patológicos e resume as causas mais comuns e os métodos de investigação para se atingir um diagnóstico nas doenças pulmonares crônicas difusas mais comuns.Descritores: Doenças pulmonares intersticiais/patologia; Tomografia computadorizada por raios X; Técnicas de diagnóstico do sistema respiratório.* Study carried out in the

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“…Radiologic and histologic features of drug-induced eosinophilic pneumonia are also indistinguishable from IAEP5). Attention must be paid to exposure to various environmental dusts, toxins or cigarette smoke through a detailed history taking and thorough laboratory tests5,6,17).…”

Section: Discussionmentioning

confidence: 99%

Idiopathic acute eosinophilic pneumonia in a 14-month-old girl

et al. 2013

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Idiopathic acute eosinophilic pneumonia (IAEP), characterized by acute febrile respiratory failure associated with diffuse radiographic infiltrates and pulmonary eosinophilia, is rarely reported in children. Diagnosis is based on an association of characteristic features including acute respiratory failure with fever, bilateral infiltrates on the chest X-ray, severe hypoxemia and bronchoalveolar lavage fluid >25% eosinophils or a predominant eosinophilic infiltrate in lung biopsies in the absence of any identifiable etiology. We present a 14-month-old girl who was admitted to our pediatric intensive care unit because of acute respiratory distress. She had a fever, dry cough, and progressive dyspnea for 1 day. Chest X-ray showed multifocal consolidations, increased interstitial markings, parenchymal emphysema and pneumothorax. IAEP was confirmed by marked pulmonary infiltrates of eosinophils in the lung biopsy specimen. Most known causes of acute eosinophilic pneumonia, such as exposure to causative drugs, toxins, second-hand smoking and infections were excluded. Her symptoms were resolved quickly after corticosteroid therapy.

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An 18-Year-Old Woman With Fever, Diffuse Pulmonary Opacities, and Rapid Onset of Respiratory Failure

Cited by 9 publications

References 9 publications

Acute eosinophilic pneumonia in the deployed military setting

Acute eosinophilic pneumonia in the deployed military setting

Padrões tomográficos das doenças intersticiais pulmonares difusas com correlação clínica e patológica

Idiopathic acute eosinophilic pneumonia in a 14-month-old girl

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