title: [Subacute extrinsic allergic alveolitis with lesion edema].
abstract: BACKGROUND
  Extrinsic allergic alveolitis may have a chronic, subacute or acute course. Its fulminant form with interstitial edema is unusual.
  
  
  METHODS
  An 11-year-old girl was referred to our intensive care unit because she suffered from high fever. Chest X-rays showed bilateral alveolitis. History revealed home exposure to several birds for many years, and episodes of dyspnea and fever for a few months. Diagnosis of extrinsic allergic alveolitis was confirmed by strongly positive results of precipitins to avian antigens. In addition, a paramyxovirus influenzae was recovered from broncho-alveolar lavage. Treatment, including high dose steroids, hydroxychloroquine, and suppression of antigenic exposure allowed weaning from mechanical ventilation after 50 days. Severe pulmonary restriction was disclosed by lung function testing following weaning and slow improvement occurred 5 months later, despite persistent interstitial lesions on chest X-rays.
  
  
  CONCLUSIONS
  Extrinsic allergic alveolitis may mimic an acute respiratory distress syndrome. Documenting bird exposure in such a case helps to achieve appropriate diagnosis which requires early administration of steroids in order to improve vital and functional prognosis.
authors.affiliation: Service de réanimation pédiatrique, hôpital Robert-Debré, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Farnoux
authors.forename: J F
authors.initials: JF
authors.lastname: Germain
authors.forename: D
authors.initials: D
authors.lastname: Pinquier
authors.forename: M
authors.initials: M
authors.lastname: Lebourgeois
authors.forename: Y
authors.initials: Y
authors.lastname: Grossi
authors.forename: F
authors.initials: F
authors.lastname: Beaufils
mesh_terms: D000208:Acute Disease; D000542:Alveolitis, Extrinsic Allergic / Q000150:complications* / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D000818:Animals; D001717:Birds; D002648:Child; D005260:Female; D006801:Humans; D011654:Pulmonary Edema / Q000150:complications* / Q000473:pathology
vernacular_title: Alvéolite allergique extrinsèque suraiguë avec oedéme lésionnel.