Agarwal Vasu, Nangia Sidhaant, Prasenan Shaily, Ganta Siri Vineeth A
Respiratory Medicine, Dr. D.Y. Patil Medical College, Hospital and Research Center, Pune, IND.
Pulmonology and Critical Care, Dr. D.Y. Patil Medical College, Hospital and Research Center, Pune, IND.
Cureus. 2024 Jul 17;16(7):e64708. doi: 10.7759/cureus.64708. eCollection 2024 Jul.
A 27-year-old female, with no significant past medical history, presented to the casualty department with a two-week history of progressive dyspnea, cough, and fever. She reported that she had recently started taking a non-conventional alternative medication for her irregular menstrual cycles. Chest radiography demonstrated bilateral alveolar opacities, and computed tomography (CT) of the chest revealed bilateral ground-glass opacities and pneumomediastinum. Laboratory testing showed peripheral blood eosinophilia, and bronchoscopy with bronchoalveolar lavage confirmed an elevated eosinophil count. Based on the clinical presentation, radiographic and laboratory findings, and exclusion of other etiologies, a diagnosis of drug-induced eosinophilic lung disease with pneumomediastinum was made. The alternative non-conventional drug was immediately discontinued and the patient was treated with systemic corticosteroids, leading to a rapid improvement in her symptoms and radiographic abnormalities. A repeat CT of the chest after 15 days revealed significant resolution of the ground-glass opacities and complete resolution of pneumomediastinum. This case highlights the importance of thorough medication history and vigilance for potential adverse effects of non-conventional treatments.
一名27岁女性,既往无重大病史,因进行性呼吸困难、咳嗽和发热两周就诊于急诊科。她报告称最近开始服用一种非传统的替代药物来治疗月经周期不规律。胸部X线检查显示双侧肺泡性混浊,胸部计算机断层扫描(CT)显示双侧磨玻璃样混浊和气纵隔。实验室检查显示外周血嗜酸性粒细胞增多,支气管镜检查及支气管肺泡灌洗证实嗜酸性粒细胞计数升高。根据临床表现、影像学和实验室检查结果,并排除其他病因,诊断为药物性嗜酸性粒细胞性肺病伴气纵隔。立即停用该非传统替代药物,并给予患者全身糖皮质激素治疗,其症状和影像学异常迅速改善。15天后复查胸部CT显示磨玻璃样混浊明显消退,气纵隔完全消失。该病例凸显了详细用药史的重要性以及对非传统治疗潜在不良反应的警惕性。