[Idiopathic chronic eosinophilic pneumonia - a diagnostic challenge]

Area of Science:

• Pulmonology
• Internal Medicine
• Hematology

Background:

• Pneumonia resistant to antibiotics presents a diagnostic challenge.
• Eosinophilic lung diseases are rare but critical differential diagnoses.

Observation:

• A 43-year-old woman presented with persistent febrile respiratory infection, cough, dyspnea, and bilateral pulmonary infiltrates despite antibiotic treatment.
• Laboratory findings revealed significant peripheral eosinophilia (31%) and eosinophils in bronchoalveolar lavage fluid.

Findings:

• Idiopathic chronic eosinophilic pneumonia was diagnosed in the absence of other causes.
• Corticosteroid therapy led to rapid normalization of clinical, laboratory, and radiological findings within one week.

Implications:

• Prompt eosinophil count is crucial for pneumonia cases unresponsive to antibiotics.
• Distinguishing between acute and chronic eosinophilic pneumonia is vital for prognosis and treatment.
• Chronic eosinophilic pneumonia requires a 6-month corticosteroid course to prevent relapses.