CRA5 ACUTE EOSINOPHILIC PNEUMONIA IN AN ADOLESCENT: A CASE REPORT

Mashkur Muhamad¹, Azlina Samsudin¹, Nurul Majidah Abdul Razak¹
¹Respiratory Unit, Hospital Sultanah Nur Zahirah, Jalan Sultan Mahmud, 20400 Kuala Terengganu, Terengganu

Introduction
Acute eosinophilic pneumonia (AEP) is a rare inflammatory lung disease characterized by acute respiratory symptoms, diffuse pulmonary infiltrates, and marked eosinophilic involvement. Although peripheral eosinophil levels may be normal early in the course, many cases show elevated levels during progression. Prompt recognition and treatment with systemic corticosteroids typically result in rapid clinical and radiological improvement, highlighting the importance of early diagnosis and intervention.

Case Report
A 14-year-old girl with no past medical history presented with a 5-day history of fever, productive cough, poor oral intake, and vomiting. There was no known sick contact or symptoms suggestive of tuberculosis. She denied smoking or vaping. On presentation, she was tachypnoeic and desaturating to 91% on room air; nasal prong oxygen at 3 L/min was started. Lung auscultation revealed fine crepitations over the bilateral lower zones. A shotty left supraclavicular lymph node was palpable. Blood tests showed a WBC count of 24,700/µL and eosinophils at 23,440/µL. Connective tissue disease screening was unremarkable. Chest X-ray showed heterogeneous opacities in the bilateral lower and mid zones. HRCT revealed ill-defined ground-glass opacities with reticular interstitial thickening, sparing the apices and superior lower lobes. She was treated with intravenous Augmentin and methylprednisolone 500 mg daily for 3 days, followed by a tapering dose of oral steroids. She was discharged well, and follow-up chest X-ray showed complete resolution.

Discussion
This case highlights the need for early recognition of AEP, which can mimic common respiratory conditions. Marked peripheral eosinophilia and bilateral infiltrates should raise suspicion. Prompt corticosteroid therapy can lead to rapid recovery.

Keywords: Acute eosinophilic pneumonia; Corticosteroid therapy; Pulmonary infiltrates