Chronic eosinophilic pneumonia in a 13-year-old child

Abstract

We report a case of a 13-year-old girl with an asymptomatic isoniazid-resistant tuberculosis contact. Six months after the contact had been made, chest radiography showed left upper lobe infiltrates without hilar lymphadenopathy, which led to the start of an antituberculous treatment. Tuberculin skin test remained negative and blood tests showed hypereosinophilia. One month after the onset of the treatment, she presented with asthenia, weight loss, and cough. She was admitted to our unit with a diagnosis of drug-resistant tuberculosis. Blood tests showed the persistence of hypereosinophilia. Chest radiograph and high-resolution lung computed tomography (CT) scan showed alveolar peripheral condensations on both upper lobes without significant hilar lymphadenopathy. Bronchoalveolar lavage (BAL) showed a normal total cell count with 44% of eosinophils. Microbiological analyses were all negative. Chronic eosinophilic pneumonia (CEP) was confirmed after the elimination of other different eosinophilic lung diseases. The patient was highly responsive to high doses of oral corticosteroids. Dyspnoea and cough disappeared within one week and chest CT scan showed regression of the lung infiltrates within one month. No relapse occurred during the following nine months.

Idiopathic eosinophilic pneumonia in children: the French experience

“…To date, only ten pediatric observations have been reported in the literature [8-14], apart from those published by our center [15-17], with no follow-up studies or series (Table 6). Diagnosis in children has relied on adult criteria [3], as used in this study.…”

Interstitial lung diseases in children

“…Eosinophilic lung diseases of known cause in children include mainly allergic bronchopulmonary aspergillosis, parasitic infections and drug reactions. Eosinophilic lung diseases of unknown cause comprise Loeffler syndrome (characterized by migrating pulmonary opacities), acute eosinophilic pneumonia, and chronic eosinophilic pneumonia [174,175]. The idiopathic hyper-eosinophilic syndrome is a rare disorder observed mainly in adults; it is characterized by prolonged eosinophilia and a multiorgan system dysfunction due to eosinophil infiltration with pulmonary involvement documented in almost half of the patients [176,177].…”

Chronic eosinophilic pneumonia with mucous plugs in a child

“…CEP may affect every age group, with a mean age at presentation of 45 years. It is extremely rare in childhood 7–9. This is the first reported case of chronic eosinophilic pneumonia presenting with mucous plugs in children described to date in the literature.…”

“…Asthma (chronic eosinophilic bronchitis), allergic bronchopulmonary aspergillosis, simple pulmonary eosinophilia (parasitic infections and drug reactions), eosinophilic vasculitis, and eosinophilic pneumonia (acute, chronic, and drug induced) are the most common pulmonary eosinophilic syndromes 1–6. Chronic eosinophilic pneumonia (CEP) is an extremely rare disease in childhood 7–9. We report a CEP with eosinophilic mucous plugs in a 7‐year‐old girl who presented with respiratory symptoms and typical radiological findings.…”

“…[1][2][3][4][5][6] Chronic eosinophilic pneumonia (CEP) is an extremely rare disease in childhood. [7][8][9] We report a CEP with eosinophilic mucous plugs in a 7-year-old girl who presented with respiratory symptoms and typical radiological findings.…”