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Simple pulmonary eosinophilia

Pulmonary infiltrates with eosinophilia; Loffler syndrome; Eosinophilic pneumonia; Pneumonia - eosinophilic

 

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

Causes

 

Most cases of this condition are due to an allergic reaction from:

  • A medicine, 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, or Necator americanus, or the hookwormAncylostoma duodenale

In some cases, no cause is found.

 

Symptoms

 

Symptoms may include any of the following:

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

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.

A procedure that removes the stomach contents (gastric lavage) may show signs of the Ascaris worm or another parasite.

 

Treatment

 

If you are allergic to a medicine, your provider may tell you to stop taking it. Never stop taking a medicine without first talking with your provider.

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

Sometimes, anti-inflammatory medicines called corticosteroids are given.

 

Outlook (Prognosis)

 

The disease often goes away without treatment. If treatment is needed, the response is usually good. But, the disease can come back, especially if the condition does not have a specific cause and needs to be treated with corticosteroids.

 

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

 

See your provider if you have symptoms that may be linked with this disorder.

 

Prevention

 

This is a rare disorder. Many times, the cause cannot be found. Minimizing exposure to possible risk factors, such as certain medicines or parasites, may reduce the chance of developing this disorder.

 

 

References

Cottin V, Cordier JF. Eosinophilic lung diseases. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 68.

Kim K, Weiss LM, Tanowitz HB. Parasitic infections. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 39.

 
  • Lungs

    Lungs - illustration

    The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.

    Lungs

    illustration

  • Respiratory system

    Respiratory system - illustration

    Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.

    Respiratory system

    illustration

    • Lungs

      Lungs - illustration

      The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.

      Lungs

      illustration

    • Respiratory system

      Respiratory system - illustration

      Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.

      Respiratory system

      illustration

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            Review Date: 6/22/2015

            Reviewed By: Denis Hadjiliadis, MD, MHS, Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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