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[Ramsay Hunt syndrome associated with eosinophilic pneumonia]
1Department of Internal Medicine, Minamitane Town Hospital, Kagoshima, Japan.
Summary
This study reports a case of eosinophilic pneumonia in a 66-year-old woman following Ramsay Hunt syndrome. The condition resolved spontaneously, suggesting an allergic reaction possibly linked to varicella-zoster virus reactivation.
Area of Science:
- Pulmonology
- Infectious Diseases
- Immunology
Background:
- A 66-year-old woman presented with dry cough and eosinophilia after facial palsy due to Ramsay Hunt syndrome (herpes zoster oticus).
- Varicella-zoster virus (VZV) reactivation can occur in sensory ganglia, potentially triggering immune responses.
Observation:
- The patient developed marked eosinophilia and pulmonary infiltrates on imaging.
- Transbronchial lung biopsy showed eosinophilic infiltration of alveolar septa and spaces.
- Bronchoalveolar lavage revealed an elevated CD4/CD8 ratio and high eosinophilic cationic protein levels.
Findings:
- Diagnosis of eosinophilic pneumonia was established.
- No parasitic or fungal infections were identified.
- Acyclovir and lymphocyte stimulation tests were negative, ruling out direct drug hypersensitivity.
Implications:
- The case suggests eosinophilic pneumonia may arise from an allergic reaction due to Th1/Th2 imbalance post-VZV reactivation.
- The condition improved spontaneously, highlighting the potential for self-resolution in certain immune-mediated lung diseases.
- This case expands understanding of atypical presentations of VZV reactivation and immune-mediated pulmonary complications.