Acute Eosinophilic Pneumonia Induced by Cigarrette Smoke

Abstract

An 18-year-old man was admitted to our hospital because of a dry cough and high fever of acute onset. A chest radiograph revealed diffuse bilateral infiltrates, mainly in peripheral lung zones. Laboratory data showed hypoxemia and leukocytosis, and no eosinophilia. The diagnosis was acute eosinophilic pneumonia, and was based on examination of a transbronchial lung biopsy specimen and on the clinical course. The patient was treated with a corticosteroid and responded quickly. We suspected that the disease was related to smoking because the patient had started smoking two days before the onset of the symptoms. Therefore, a challenge test was done in which the patient smoked cigarettes. By 15 hours after the challenge, he had become severely hypoxemic and by 21 hours after the challenge his pulmonary function had decreased. In this patient, smoking cigarettes appeared to have induced acute eosinophilic pneumonia.