Acute eosinophilic pneumonia after recent start of smoking

Repeat chest radiograph showed progressive bilateral infiltrations and a right-sided pleural effusion, but unexpectedly C-reactive protein had decreased from 92 mg/L to 32 mg/L. Because our patient had a pneumonia that was not resolving with standard antibiotic treatment we widened our differential...

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Bibliographic Details
Published in:The Lancet (British edition) 2015-03, Vol.385 (9973), p.1150-1150
Main Authors: Brackel, Caroline L H, Dr, Ropers, Fabienne G, MD, Vermaas-Fricot, Sophie F N, MD, Koens, Lianne, MD, Willems, Luuk N A, PhD, Rikkers-Mutsaerts, Eleonora R V M, MD
Format: Article
Language:English
Subjects:
Acute Disease
Adolescent
Antibiotics
Female
Humans
Internal Medicine
Medical diagnosis
Medical treatment
Pneumonia
Pulmonary Eosinophilia - etiology
Smoking
Smoking - adverse effects
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Summary:Repeat chest radiograph showed progressive bilateral infiltrations and a right-sided pleural effusion, but unexpectedly C-reactive protein had decreased from 92 mg/L to 32 mg/L. Because our patient had a pneumonia that was not resolving with standard antibiotic treatment we widened our differential diagnosis to include antimicrobial failure due to resistant or unusual micro-organisms (such as legionella), infectious complications (such as Staphylococcus aureus empyema), and noninfectious causes such as chemical pneumonitis, eosinophilic pneumonia, vasculitis, or diffuse lung disease.1 We changed the antibiotics to flucloxacillin and ciprofloxacin.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(15)60128-3