What is eosinophilic pneumonia?
Eosinophilic pneumonia is a rare disease in which eosinophils (a type of white blood cells) accumulate in the lungs and, often, in blood.
Unlike other types of pneumonia, eosinophilic pneumonia is not caused by an infection but probably by an allergic reaction [1].
Synonyms: pulmonary infiltrates with eosinophilia syndrome, eosinophilic pneumonitis [1,5].
Causes
- Smoking cigarettes, crack cocaine or heroin
- Drugs, such as amiodarone, aminosalicylic acid, calcium stearate (additive agent for oral antihistamine), carbamazepine, chlorpropamide, isoniazid, naproxen, nitrofurantoin, penicillin, phenytoin, progesterone, ranitidine, sertraline, trazodone, trimethoprim/sulfamethoxazole [6]
- Supplements, such as L-tryptophan
- Inhalation of nickel carbonyl vapors or smoke from fireworks
- Inhalation of fungi, such as Aspergillus fumigatus and Candida
- Intestinal worms, such as Ascaris, mainly in persons with HIV/AIDS
- Diseases, such as HIV/AIDS and eosinophilic granulomatosis with polyangiitis (formerly Churg-Strauss syndrome), allergic bronchopulmonary aspergillosis and tropical pulmonary eosinophilia (mainly in South Asia)
- References: [1,2,6]
When the cause remains unknown, the condition is called idiopathic eosinophilic pneumonia.
Individuals with asthma, hay fever and allergies to drugs are at increased risk [6].
Symptoms
A person with acute eosinophilic pneumonia can experience a dry cough, fever and chest pain triggered by deep breathing; symptoms usually last for less than 7 days. The condition can become life-threatening within few hours or days.
Chronic eosinophilic pneumonia can cause about the same symptoms than the acute one but can lasts for several weeks or months and frequently recur [1].
A mild form of eosinophilic pneumonia, usually as a reaction to intestinal parasites, is called Löffler syndrome [4].
Diagnosis
A doctor can make a diagnosis of eosinophilic pneumonia from increased number of eosinophils in the blood and samples obtained by bronchoscopy and from chest X-ray and computer tomography (CT) images [1].
Treatment
Eosinophilic pneumonia is usually treated with corticosteroids (prednisone), sometimes for more than a year [1]. In severe cases, a person may need mechanical ventilation.
Prognosis. With treatment, a complete recovery is usual; spontaneous healing may also occur [1,6].
- References
- Harold R et al, Eosinophilic Pneumonia Merck Manuals, Consumer Version
- Lau SKP et al, 2007, Ascaris induced eosinophilic pneumonitis in an HIV infected patient PubMed Central
- Sharma, GD, Loffler syndrome Emedicine
- Miles MC et al, Allergic Bronchopulmonary Aspergillosis (ABPA) Merck Manual, Professional Version
- Miller BA et al, 2010, Acute Eosinophilic Pneumonia Secondary to Daptomycin: A Report of Three Cases Clinical Infectious Disease
- Guinee DG, Pathology of Eosinophilic Pneumonia Emedicine