Acute pulmonary eosinophilia (Loeffler's syndrome)

Alternative names:

eosinophilic pneumonia; Loeffler's syndrome; pulmonary infiltrates with eosinophilia

Symptoms:

• general ill feeling (malaise)
• loss of appetite
• fever lasting 2 to 3 days
• cough that is productive of mucus-like phlegm (mucoid sputum)
• chest pain
• shortness of breath
• wheezing
• rapid respiratory rate
• headache
• muscle pain

Note: Symptoms may be mild, severe, or not present. Symptoms will usually resolve spontaneously.

Signs and tests:

Listening to the chest with a stethoscope (auscultation) reveals fluid in the lungs, and may reveal a friction rub.

• A bronchoscopy shows hypersensitivity reaction.
• An open lung biopsy shows hypersensitivity reaction.
• A CBC or WBC count shows increased white blood cells, particularly eosinophils. The blood differential may also be abnormal.

These tests also confirm the diagnosis:

• sputum smear (KOH test)
• chest X-ray