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Simple pulmonary eosinophilia

Definition

Simple pulmonary eosinophilia is inflammation of the lungs associated with an increase in eosinophils, a type of white blood cell.

Alternative Names

Pulmonary infiltrates with eosinophilia; Loeffler syndrome

Causes, incidence, and risk factors

Most cases of simple pulmonary eosinophilia are due to an allergic reaction, either from a drug, such as sulfonamide, or infection with a fungus or parasite, including Ascaris lumbricoides.

Symptoms

• Chest pain
• Dry cough
• Fever
• General ill feeling
• Rapid respiratory rate
• Rash
• Shortness of breath
• Wheezing

The symptoms can range from none at all to severe. They may go away without treatment.

Signs and tests

The health care provider will listen to your chest with a stethoscope. Crackle-like sounds called rales may be heard. Rales suggest inflammation of the lung tissue.

A blood count test shows increased white blood cells, particularly eosinophils.

Chest x-ray usually shows abnormal shadows called infiltrates. They may disappear with time or reappear in different areas of the lung.

A bronchoscopy with washing may show a large number of eosinophils.

Gastric lavage may show signs of the ascaris worm.

Treatment

If you are allergic to a drug, the doctor may have you stop taking it. (But, never stop a medication without consulting with your doctor first.)

If the condition is due to an infection, you may be treated with an antibiotic or anti-parasitic medication.

Sometime, corticosteroids (powerful anti-inflammatory medicines) may be needed.

Expectations (prognosis)

The disease often goes away without treatment. If treatment is needed, the response is usually good. However, relapses can occur (the disease comes back).

Complications

A rare complication of simple pulmonary eosinophilia is a severe type of pneumonia called acute idiopathic eosinophilic pneumonia.

Calling your health care provider

See your health care provider if you have symptoms that may be linked with this disorder.

Prevention

This is a rare disorder. Many times, the cause cannot be found. Minimizing exposure to possible risk factors (certain medicines, some metals) may reduce risk.

References

Mason RJ, Murray J, VC Broaddus, Nadel J. Textbook of Respiratory Medicine. 3rd ed. Philadelphia, Pa: WB Saunders; 2005:1679-1695.

Grainger RC, Allison D, Adam, Dixon AK. Diagnostic Radiology: A Textbook of Medical Imaging. 4th ed. Orlando, Fl: Churchill Livingstone; 2001:600,895.