Initial Lab finding

   WBC 11900/mm3  (Seg: 74%,   Eosinophil: 5%)
   ABGA ; pO2 47.6 mmHg,   SaO2 82.9%

Bronchoalveolar lavage
  Eosinophil 76%
           

Brief Discussion

Diagnostic criteria

    Acute febrile illness <5 days

    Hypoxemia

    Diffuse alveolar or intersititial infiltration on CXR

    Bronchoalveolar lavage  eosinophils > 25%

    Absence of parasitic, fungal or other infection

    Prompt and complete response to corticosteroids

    Failure to relapse after discontinuation of steroids

Cause ; idiopathic
    Infection – mycotic (aspergillus), helminths

    Inhalation of toxic substances

    Drug overdose

    Exposure to aerosolized pentamidine

    Relation of cigarette smoking

CT findings

 ; bilateral interstitial and air-space consolidation

   Poorly defined nodules

   Interlobular septal thickening

   Pleural effusion

   “Photographic negative of pulmonary edema”,  “Reverse bat wing sign”

Differential diagnosis

   Pulmonary edema

   Acute respiratory distress syndrome

   Acute interstitial pneumonia

   Atypical bacterial or viral pneumonia

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