Fatal Eosinophilic Pulmonary Vasculitis in a Neonate - The First Documented Case in the English Literature

This case presentation offers an in-depth exploration of the complex and multifaceted realm of neonatal eosinophilic vasculitis, an extremely rare entity that has not been reported in the English literature. Only one similar case has been described in an Italian publication in 1995. Our case places an emphasis on the clinical presentation, postmortem findings, and evaluation of the importance of a multidisciplinary approach to this enigmatic disease.

We report a case of a 33-week neonate born via cesarean section following premature preterm rupture of membranes who died of an unknown etiology within the first 30 minutes of life despite maximal resuscitation efforts. A limited postmortem examination of only the lungs and heart was requested and revealed a necrotizing eosinophilic vasculitis of the lungs; these histopathologic findings are extremely uncommon in the neonate population.

In other patient groups, eosinophilic vasculitis is a hallmark of several interstitial lung diseases. The etiology widely ranges from viral, fungal, parasitic infections, allergic reactions, hypereosinophilic syndrome, and various vasculitis types such as eosinophilic granulomatosis with polyangiitis (formerly Churg-Strauss syndrome) and granulomatosis with polyangiitis. The potentially fatal outcome for neonates and the lack of a clear etiology identified in the neonatal population necessitates urgent attention to this rare condition.