Makindo Medical Notes.com

Related Subjects: Asthma |Acute Severe Asthma |Eosinophilic granulomatosis (Churg Strauss) |Loffler's syndrome (Pulmonary Eosinophilia) |Pulmonary Eosinophilia and CXR changes |Drug Reaction Eosinophilia Systemic Symptoms

Common CXR Changes in Pulmonary Eosinophilia

• Peripheral Pulmonary Infiltrates: The most common CXR finding in pulmonary eosinophilia is the presence of peripheral pulmonary infiltrates. These infiltrates are often non-segmental and can appear as patchy areas of increased opacity. The "photographic negative of pulmonary oedema" is a classic description where the infiltrates are peripheral and not central, unlike typical pulmonary oedema.
• Ground-Glass Opacities: These are areas of hazy increased attenuation in the lungs with preserved bronchial and vascular markings. Ground-glass opacities can be diffuse or localized and are often seen in acute eosinophilic pneumonia.
• Reticular Patterns: Some patients may develop a reticular (net-like) pattern on the CXR, indicative of interstitial involvement. This can occur in chronic eosinophilic pneumonia.
• Consolidation: In some cases, there may be areas of consolidation where the lung tissue becomes solid due to filling of the air spaces with fluid, cells, and other substances. This is more common in chronic forms of the disease.
• Normal CXR: Occasionally, patients with pulmonary eosinophilia may have a normal CXR, especially in early or mild cases.

Causes of Severe: > 5 x 10⁹

• Allergic Bronchopulmonary Aspergillosis
• Chronic eosinophilic pneumonia
• Hyper eosinophilic syndrome - eosinophilia, restrictive cardiomyopathy and hepatosplenomegaly
• Acute eosinophilic pneumonia
• Löffler's Syndrome e.g. Parasitic infections, especially Ascaris lumbricoides
• Drug-induced pneumonitis (e.g. Antibiotics, Phenytoin, l-tryptophan), cocaine
• Eosinophilic leukaemia

Causes of Less severe: 0.5-2.0 x 10⁹

• Churg-Strauss syndrome
• Hodgkin's lymphoma