Acute eosinophilic pneumonia associated with shock

• Published in: Critical care medicine Vol. 27; no. 9; pp. 2014 - 2016
• Main Authors: Buddharaju, Venkata L, Saraceno, Joseph L, Rosen, Jonathan M, Spivack, Simon D, Smith, Thomas C, Ilves, Riivo, Killam, Donald A, McKenna, Barbara J
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins, Inc 01-09-1999; Lippincott
• Subjects: Acute Disease; Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Bronchoalveolar Lavage Fluid; Emergency and intensive respiratory care; Humans; Intensive care medicine; Male; Medical sciences; Pulmonary Eosinophilia - complications; Pulmonary Eosinophilia - diagnosis; Respiratory Insufficiency - etiology; Shock - etiology; Shock; Human; Lung disease; Intensive cardiocirculatory care; Pneumonia; Intensive care; Pathophysiology; Respiratory disease; Acute; Cardiovascular disease; Respiratory intensive care; Eosinophilia; Case study; Concomitant disease; Treatment; Respiratory failure; Diagnosis; Hemodynamics
• ISSN: 0090-3493; 1530-0293
• DOI: 10.1097/00003246-199909000-00048

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.