[Pneumonia, when sound waves mix things up].

Rev Med Brux

Département de Médecine Interne, H.I.S., Site Etterbeek-lxelles, Bruxelles.

Published: March 2012

A 29-year old man is admitted in our hospital for a dry cough which appeared a few weeks earlier and is now associated with a breath depending thoracic pain. As an engineer, he is realizing a thesis about the sound waves produced by coughing and is therefore frequently exposed to patients with various pulmonary infections. The chest X-ray, presents predominant pulmonary infiltrates on the periphery of the upper fields of the lungs. Blood analysis revealed a hypereosinophilia of 4.650/microl. The various bacteriological, parasitic and viral investigation tests are negative. The bronchioalveolar washing reveals more than 50% eosinophils. Exclusive pulmonary impairment and lack of autoantibody moved us to the diagnosis of chronic eosinophilic pneumonia (or Carrington syndrome). Corticosteroids were started at the dosis of 0,5 mg/kg of methyl-prednisolone. Clinical and biological features improved amazingly within 48 hours. This case report illustrates the overlap between the chronic eosinophilic pneumonia and the Churg-Strauss desease who can be considered as variants of the hypereosinophilic syndrome (HES). Therefore, the use of anti-interleukin-5 antibodies, already used in the SHE and Churg-Strauss syndrome, might be useful in this case.

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