Eosinophilic pneumonia

There is a broad spectrum of disease encompassed by the various forms of eosinophilic pneumonia. Variations in both clinical course and histologic picture make these conditions difficult to classify. A case is reported of an 18-year-old black female, seven weeks postpartum, who presented with distinctive subcutaneous nodules on her extremities. These progressed to include edema and pruritus of both feet and one arm. She had been taking only oral contraceptives for six weeks. While in the hospital, she developed fevers to 104 F, cough, shortness of breath, and eventual respiratory insufficiency requiring intubation and ventilatory assistance. Chest x-ray films revealed diffus infiltrates. Lung biopsy revealed chronic interstitial organizing pneumonia with vasculitis and marked eosinophilia. She responded dramatically to high dose steroids and recovered. After careful literature review, this case fits best in the category of Carrington chronic eosinophilic pneumonia. It is unusualy in its dermatologic presentation and its fulminant development of respiratory insufficiency.