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Simple pulmonary eosinophilia
Definition
Simple pulmonary eosinophilia is swelling (inflammation) of the lungs from an increase in eosinophils, a type of white blood cell.
Alternative Names
Pulmonary infiltrates with eosinophilia; Loeffler syndrome
Causes
Most cases of simple pulmonary eosinophilia are due to an allergic reaction from:
- A drug, such as a sulfonamide antibiotic or nonsteroidal anti-inflammatory drug (NSAID)
- Infection with a fungus such as Aspergillus fumigatus or Pneumocystis jirovecii
- A parasite, including the roundworms Ascariasis lumbricoides, Necator americanus, or Ancylostoma duodenale (hookworms)
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.
Exams 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 complete blood count (CBC) may show 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 or another parasite.
Treatment
If you are allergic to a drug, the doctor may tell you to stop taking it. (Never stop taking a medication without first talking with your doctor.)
If the condition is due to an infection, you may be treated with an antibiotic or anti-parasitic medication.
Sometimes, you may need corticosteroids (powerful anti-inflammatory medicines).
Outlook (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).
Possible Complications
A rare complication of simple pulmonary eosinophilia is a severe type of pneumonia called acute idiopathic eosinophilic pneumonia.
When to Contact a Medical Professional
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
Cottin V, Cordier JF. Eosinophilic lung diseases. In: Mason RJ, Broaddus VC, Martin TR, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 61.
McCarthy J, Nutrman TB. Parasitic lung infections. In: Mason RJ, Broaddus VC, Martin TR, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 37.
Raghu G. Interstitial lung disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 92.
Reviewed By: David C. Dugale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Denis Hadjuliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
