DIAGNOSES AND DISCUSSION OF CHALLENGING CLINICAL CASE NO. 01/2001
Chronic eosinophilic pneumonia
| Chronic eosinophilic pneumonia is an interstitial lung disorder of unknown cause that produces a systemic illness characterized by fever, weight loss, and malaise. Although lung biopsy shows an eosinophilic infiltrate involving both the interstitium and the alveolar space, there may not be an associated eosinophilia in the blood. The diagnosis should be suggested by the” photonegative pulmonary edema “pattern, with central sparing and nonsegmental, patchy infiltrates in the lungperiphery. This disorder often responds dramatically to corticosteriod therapy. Idiopathic pulmonary fibrosis and polymyositis produce diffuses reticular, nodular, or reticulonodular infiltrates on chest X – ray. Alveolar proteinosis is a rare disorder that most often produces a diffuse air – space filling pattern radiating from hilar regions on on chest X – ray, often with air bronchograms. Alveolar proteinosis does not cause fever unless complicated by infection such as nocardiosis. Lymphangiomyomatosis is also rare. It occurs exclusively in woman of childbearing age. The chest X – ray shows reticulonodular infiltration but the lungs often appear hyprinflated. Pleural effusion and pneumothorax complicate Lymphangiomyomatosis, but not fever. |