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대한흉부영상의학회 Weekly Case 검색
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Weekly Chest CasesImaging Conference Cases

Case No : 4

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  • Age/Sex 25 / M
  • Case Title Cough, sputum, and fever from three days ago
  • Figure 1
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  • Figure 6

Diagnosis With Brief Discussion

Courtesy
Kyunghee University Hospital
Discussion
Diagnostic Workup



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

밣hotographic negative of pulmonary edema? 밨everse bat wing sign?

Differential diagnosis

Pulmonary edema

Acute respiratory distress syndrome

Acute interstitial pneumonia

Atypical bacterial or viral pneumonia

Reference
Diagnostic Workup



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

밣hotographic negative of pulmonary edema? 밨everse bat wing sign?

Differential diagnosis

Pulmonary edema

Acute respiratory distress syndrome

Acute interstitial pneumonia

Atypical bacterial or viral pneumonia

Keywords
Lung, Eosinophilic lung disease,
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