Acute eosinophilic pneumonia. Case report and review of the literature

: A 37 year old female smoker was admitted with an acute episode of fever and pulmonary infiltrates followed by respiratory failure requiring mechanical ventilation in less than 24 hours. After empiric antibiotic therapy fiberoptic bronchoscopy and bronchoalveolar lavage (BAL) were carried out. Abnormal findings were limited to highly increased eosinophilic count in BAL. Blood eosinophils were normal. Acute eosinophilic pneumonia was diagnosed and methyl prednisolone was administered; 48 hours afterwards, infiltrates had partially resolved and the patient was weaned from ventilator. After two years follow up, she has not had recurrences of the episode, is asymptomatic and her chest Xray is normal. A review of the literature is presented and physiopathological mechanisms for acute eosinophilic pneumonia are considered. Acute eosinophilic pneumonia is a rare but potentially curable cause of respiratory failure that should be included in diagnostic considerations.