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Acute eosinophilic pneumonia associated with shock

Buddharaju, Venkata L. MD; Saraceno, Joseph L. DO, FCCP; Rosen, Jonathan M. MD, FCCP; Spivack, Simon D. MD, FCCP; Smith, Thomas C. MD, FCCP; Ilves, Riivo MD; Killam, Donald A. MD; McKenna, Barbara J. MD

Case Report

Objective: To describe an unusual case of acute eosinophilic pneumonia (AEP) associated with hemodynamic instability.

Design: Case report, clinical.

Settings: Tertiary care intensive care unit (ICU).

Patient: A single patient admitted to the ICU.

Interventions: Intravenous corticosteroids.

Measurements and Main Results: Resolution of distributive shock and respiratory failure.

Conclusions: AEP with respiratory failure was first reported in 1989 as a distinct clinical entity. Patients with this variant of eosinophilic lung disease develop acute hypoxemic respiratory failure with a rapid response to treatment with corticosteroids. The characteristic feature of this syndrome is a predominance of eosinophils found in bronchoalveolar lavage fluid and lung biopsy. Despite the increasing number of reported cases, to our knowledge, distributive shock has not been reported as a feature of AEP. We report a unique case of AEP associated with shock and review the pertinent literature.

From the Division of Pulmonary and Critical Care (Drs. Buddharaju, Saraceno, Rosen, Spivack, and Smith), the Division of Cardiothoracic Surgery (Dr. Ilves), the Department of Radiology (Dr. Killam), and the Department of Pathology (Dr. McKenna), Albany Medical College, Albany, NY.

Address requests for reprints to: Dr. Joseph L. Saraceno, Long Island Pulmonary Associates, 1 Fulton Avenue, Hempstead, NY 11550.

© 1999 Lippincott Williams & Wilkins, Inc.