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    Simple pulmonary eosinophilia

    Pulmonary infiltrates with eosinophilia; Loeffler syndrome

    Simple pulmonary eosinophilia is swelling (inflammation) of the lungs from an increase in eosinophils, a type of white blood cell.

    Causes

    Most cases of simple pulmonary eosinophilia are due to an allergic reaction from:

    • A drug, such as a sulfonamide antibiotic or nonsteroidal anti-inflammatory drug (NSAID)
    • Infection with a fungus such as Aspergillus fumigatus or Pneumocystis jirovecii
    • A parasite, including the roundworms Ascariasis lumbricoides, Necator americanus, or Ancylostoma duodenale (hookworms)

    Symptoms

    • Chest pain
    • Dry cough
    • Fever
    • General ill feeling
    • Rapid respiratory rate
    • Rash
    • Shortness of breath
    • Wheezing

    The symptoms can range from none at all to severe. They may go away without treatment.

    Exams and Tests

    The health care provider will listen to your chest with a stethoscope. Crackle-like sounds called rales may be heard. Rales suggest inflammation of the lung tissue.

    A complete blood count (CBC) may show increased white blood cells, particularly eosinophils.

    Chest x-ray usually shows abnormal shadows called infiltrates. They may disappear with time or reappear in different areas of the lung.

    A bronchoscopy with washing may show a large number of eosinophils.

    Gastric lavage may show signs of the Ascaris worm or another parasite.

    Treatment

    If you are allergic to a drug, the doctor may tell you to stop taking it. (Never stop taking a medication without first talking with your doctor.)

    If the condition is due to an infection, you may be treated with an antibiotic or anti-parasitic medication.

    Sometimes, you may need corticosteroids (powerful anti-inflammatory medicines).

    Outlook (Prognosis)

    The disease often goes away without treatment. If treatment is needed, the response is usually good. However, relapses can occur (the disease comes back).

    Possible Complications

    A rare complication of simple pulmonary eosinophilia is a severe type of pneumonia called acute idiopathic eosinophilic pneumonia.

    When to Contact a Medical Professional

    Prevention

    References

    Cottin V, Cordier JF. Eosinophilic lung diseases. In: Mason RJ, Broaddus VC, Martin TR, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 61.

    McCarthy J, Nutrman TB. Parasitic lung infections. In: Mason RJ, Broaddus VC, Martin TR, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 37.

    Raghu G. Interstitial lung disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 92.

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            Tests for Simple pulmonary eosinophilia

              Review Date: 6/2/2011

              Reviewed By: David C. Dugale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Denis Hadjuliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

              The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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