Acute eosinophilic pneumonia masquerading as multiple pulmonary embolisms

Area of Science:

• Pulmonology
• Environmental Medicine
• Diagnostic Imaging

Background:

• Acute eosinophilic pneumonia (AEP) is an uncommon respiratory condition often associated with environmental exposures.
• Atypical presentations of AEP can pose diagnostic challenges, particularly when radiological findings are unusual.

Observation:

• A 47-year-old man presented with acute respiratory symptoms including fever, cough, and dyspnea.
• Thoracic imaging revealed extensive bilateral consolidation and scattered nodules, predominantly in the upper lung lobes.
• A recent visit to a 100-year-old Japanese folk house was identified during detailed patient history.

Findings:

• Bronchoscopy results confirmed the diagnosis of acute eosinophilic pneumonia (AEP).
• The patient's symptoms resolved spontaneously within 10 days, indicating a favorable prognosis.
• The radiological findings, while atypical, were consistent with AEP in the context of the exposure history.

Implications:

• This case highlights the importance of thorough patient history, including environmental exposures, in diagnosing AEP.
• Even with atypical imaging, a detailed history can facilitate rapid and accurate diagnosis of AEP.
• Early diagnosis and recognition of AEP, even in unusual presentations, can lead to effective management and recovery.