Hogan T F, Riley R S, Thomas J G
Department of Medicine, West Virginia University, Robert C. Byrd Health Sciences Center, Morgantown 26506-9162, USA.
J Clin Lab Anal. 1997;11(4):202-7. doi: 10.1002/(sici)1098-2825(1997)11:4<202::aid-jcla5>3.0.co;2-a.
A diagnosis of exclusion, acute eosinophilic pneumonia (AEP) is an acute febrile illness with respiratory impairment, diffuse pulmonary infiltrates, and bronchoalveolar lavage (BAL) fluid eosinophilia. Whether pulmonary eosinophilia in AEP is primary or secondary remains undetermined. We report here a 22-year-old auto mechanic with severe AEP and acute respiratory failure who required intubation and ventilatory support. The patient's bronchoalveolar lavage (BAL) fluid was analyzed using cultures, cytology, Wright/Giemsa, Gram, Gomori-methenamine-silver (GMS), and calcofluor white (CW) stains (1). Despite extensive evaluation, no infectious etiology was found. CW staining helped us rapidly to exclude Pneumocystis carinii or fungal infection and to focus attention toward the diagnosis of AEP. Transbronchial biopsy was unnecessary and supportive therapy without systemic glucocorticoids was followed by recovery within a few weeks. In this case, bronchoalveolar lavage with CW staining was of great assistance in the rapid diagnosis and initial management of AEP. Our literature review found no prior article using CW staining for evaluation of AEP.
急性嗜酸性粒细胞性肺炎(AEP)是一种排除性诊断,是一种伴有呼吸功能损害、弥漫性肺浸润及支气管肺泡灌洗(BAL)液嗜酸性粒细胞增多的急性发热性疾病。AEP中的肺嗜酸性粒细胞增多是原发性还是继发性尚不确定。我们在此报告一名22岁的汽车修理工,患有严重的AEP及急性呼吸衰竭,需要插管和通气支持。对该患者的支气管肺泡灌洗(BAL)液进行了培养、细胞学、瑞氏/吉姆萨染色、革兰氏染色、戈莫里甲胺银(GMS)染色及荧光增白剂(CW)染色分析(1)。尽管进行了广泛评估,但未发现感染性病因。CW染色帮助我们迅速排除卡氏肺孢子虫或真菌感染,并将注意力集中于AEP的诊断。经支气管活检并无必要,未使用全身糖皮质激素的支持治疗使患者在数周内康复。在该病例中,BAL液CW染色对AEP的快速诊断及初始治疗有很大帮助。我们的文献综述未发现之前有使用CW染色评估AEP的文章。