Chronic Eosinophilic Pneumonia As Presented by Brett W. Baskovich…

What is it? Pneumonia Eosinophilic Chronic

Causes of Eosinophilic Pneumonia Churg-Strauss Syndrome Allergic Bronchopulmonary Aspergillosis Medications/Drugs/Toxins –N–N–N–Nitrofurantoin, ampicillin, ibuprofen, naproxen, phenytoin, sulfasalazine, tetracycline Parasites- Löffler's syndrome

Symptoms Cough Fever Shortness of breath Night sweats Wheezing Weight loss

Diagnosis Typically made 7 mo. after sx begin Bronchoalveolar lavage

Treatment Option 1: Steroids

Treatment Prednisone 40 – 60 mg/day –C–C–C–Continue until Sx and CXR resolved (4-6 weeks) –C–C–C–Cut dose in half (8 weeks) –R–R–R–Reduce by 5 mg every 4 weeks

Treatment Maintain patient on minimum possible dose Switch to alternate-day prednisone Add inhaled corticosteroids

Treatment High-dose inhaled corticosteroid –B–B–B–Beclometasone dipropionate 1,600 mcg/day

References Chronic eosinophilic pneumonia complicated by bronchial asthma and diabetes mellitus successfully treated with suplatast tosilate and high- dose inhaled corticosteroid therapy. Fujimori K, Shimatsu Y et al. Nihon Kokyuki Gakkai Zasshi Nov;37(11): Chronic eosinophilic pneumonia: treatment with inhaled corticosteroids. Minakuchi M, Niimi A et al. Respiration Jul-Aug;70(4): Eosinophilic lung diseases: a clinical, radiologic, and pathologic overview. Jeong YJ, Kim KI et al. Radiographics May-Jun;27(3):617-37; discussion Chronic eosinophilic pneumonia. Edwards LT, Fulmer JM et al. BUMC Proceedings. 1999;12: Chronic eosinophilic pneumonia: a review. Alam M, Burki NK. South Med J Jan;100(1):49-53.