A Case of Pneumocystis Pneumonia Mimicking Acute Eosinophilic Pneumonia in a Patient with AIDS.

Lee, Bo Ra; Kim, Hyun Kook; Park, I Nae; Choi, Sang Bong; Jung, Hoon; Lee, Hyun Kyung; Lee, Sung Soon; Lee, Young Min; Lee, Hyuk Pyo; Choi, Soo Jeon; Yum, Ho Kee

doi:2010.68.2.97

Tuberc Respir Dis > Volume 68(2); 2010 > Article

Case Report

Tuberculosis and Respiratory Diseases 2010;68(2):97-100.
DOI: https://doi.org/10.4046/trd.2010.68.2.97 Published online February 1, 2010.

A Case of Pneumocystis Pneumonia Mimicking Acute Eosinophilic Pneumonia in a Patient with AIDS.

Bo Ra Lee, Hyun Kook Kim, I Nae Park, Sang Bong Choi, Hoon Jung, Hyun Kyung Lee, Sung Soon Lee, Young Min Lee, Hyuk Pyo Lee, Soo Jeon Choi, Ho Kee Yum

Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea. pulho@korea.com

Abstract

73-year-old man was admitted with a sudden onset of dyspnea. He had never smoked. The chest radiograph and computed tomography revealed bilateral ground glass opacity and an enlarging perihilar consolidation with lymphadenopathies. There was a higher percentage of eosinophils (72%) in the bronchoalveolar lavage fluid (BALF) than normal. The patient was diagnosed with acute eosinophilic pneumonia and managed with steroid. Pneumocystis pneumonia (PCP) was diagnosed by an examination of the BALF, and the patient was treated with trimethoprim-sulphamethoxazole. The patient tested positive to the HIV antibody and the peripheral blood CD-4 positive lymphocyte count was only 33/microliter. The percentage of eosinophils in the BALF can increase in some cases of PCP that is complicated with AIDS. Only a few cases of eosinophilic pneumonia associated with PCP pneumonia have been reported in patients with AIDS but there are no case reports in Korea. This case highlights the need to consider PCP when the percentage of eosinophils in the BALF is elevated.

Key Words: Pneumocystis, Eosinophils, Acquired Immunodeficiency Syndrome