CTICasesAcute Eosinophilic Pneumonia
Imaging findings
Serial chest radiographs in a young female college student show rapid development of diffuse, bilateral peripheral consolidation, septal lines, and a pleural effusion over a 16-hour period, requiring mechanical ventilation. Chest CT demonstrates extensive, bilateral ground-glass and consolidative opacities with pleural fluid. Bronchoscopy reveals 71% eosinophils in lavage fluid, and blood eosinophilia develops five days later, with rapid clearing within 12 hours of starting steroids.
Key takeaways
Acute eosinophilic pneumonia (AEP) is a rare, acute respiratory illness characterized by rapid onset of fever, dyspnea, and diffuse pulmonary infiltrates, which can progress to respiratory failure mimicking ARDS. Unlike chronic eosinophilic pneumonia, AEP is not typically associated with asthma, and peripheral eosinophilia is often absent at presentation. Lavage fluid showing more than 25% eosinophils is diagnostic, and AEP is highly responsive to corticosteroid therapy.
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