Acute eosinophilic pneumonia in the deployed military setting

Area of Science:

• Pulmonary Medicine
• Critical Care Medicine
• Respiratory Diseases

Background:

• Acute eosinophilic pneumonia (AEP) is a rare cause of severe respiratory failure.
• Etiologies include smoking, medications, drugs, infections, and environmental exposures.
• Disease severity varies, not always necessitating mechanical ventilation or oxygen support.

Purpose of the Study:

• Compare AEP patients at LRMC to published series.
• Provide recommendations for AEP diagnosis and treatment.

Main Methods:

• Retrospective chart review of 43 AEP cases.
• Data collected from March 2003 to March 2010 at LRMC, Germany.

Main Results:

• 91% of patients reported tobacco smoking.
• Fever (>100.4°F) present in 33% at presentation.
• Peripheral eosinophilia (>5%) in 35% initially, 72% during hospitalization.
• Higher bronchoalveolar lavage (BAL) eosinophilia correlated with less severe hypoxemia (PaO2/FiO2 ratio).

Conclusions:

• Recommend adjustments to diagnostic criteria for AEP.
• Clinical clues can aid in identifying AEP.
• Higher BAL eosinophilia correlates with less severe hypoxemia, similar to peripheral eosinophilia findings.