Natarajan Aparna, Shah Payal, Mirrakhimov Aibek E, Hussain Nasir
Department of Internal Medicine, Saint Joseph Hospital, Chicago, Illinois, USA.
BMJ Case Rep. 2013 May 2;2013:bcr2013009001. doi: 10.1136/bcr-2013-009001.
A 29-year-old Caucasian man presented for the evaluation of a new onset of shortness of breath associated with cough and wheeze for 1 day. The history was significant for a recent travel of 20 h duration to Houston, a new onset of cigarette smoking for 2 weeks and marijuana smoking. The patient was afebrile and did not have any leg swelling; initial diagnosis of community-acquired pneumonia was made and the patient was started on antibiotics. Despite being on antibiotics, his medical condition continued to deteriorate and extensive diagnostic workup for infectious and autoimmune aetiology including bronchoalveolar lavage was completed and was inconclusive. Ultimately, the patient underwent video-assisted thoracoscopic lung biopsy which led to the diagnosis of acute eosinophilic pneumonia. Steroids were started with a good treatment response. The patient was discharged on a tapering dose of steroids; a follow-up chest x ray at 6 weeks was within normal limits.
一名29岁的白人男性因新发气短伴咳嗽和喘息1天前来评估。病史显示近期有一次长达20小时的休斯顿之行，两周前开始吸烟且吸食大麻。患者无发热，无腿部肿胀；初步诊断为社区获得性肺炎，患者开始使用抗生素治疗。尽管使用了抗生素，他的病情仍持续恶化，完成了包括支气管肺泡灌洗在内的针对感染性和自身免疫性病因的广泛诊断检查，但结果尚无定论。最终，患者接受了电视辅助胸腔镜肺活检，诊断为急性嗜酸性粒细胞性肺炎。开始使用类固醇治疗，治疗反应良好。患者出院时使用逐渐减量的类固醇；6周后的胸部X线随访结果正常。
