[A case of AIDS-complicated lung infection mimicking acute eosinophilic pneumonia].
A 34-year-old man was admitted with dyspnea and low grade fever. Chest radiograph and computed tomography (CT) showed bilateral, ground glass opacities and perihilar consolidation. Bronchoalveolar lavage (BAL) was performed. The percentage of eosinophils in the BAL fluid (BALF) was elevated (20.5%). BALF smear and culture showed normal flora. Acute eosinophilic pneumonia was diagnosed and steroid therapy was performed. Afterwards he was transferred to our hospital. The HIV antibody was positive and peripheral blood CD-4 positive lymphocytes decreased to 10/microl, cytomegalovirus (CMV) antigenemia was positive and beta-D-glucan increased. CMV infection and pneumocystis pneumonia (PCP) complicated with AIDS was diagnosed. Trimethoprim/sulfamethoxazole, ganciclovir, and antifungal drugs were administered, but he suffered pneumothorax on the 18th day after admission and died. Histopathologic findings from an autopsy lung specimen revealed CMV infection and PCP. It is known that the percentage of eosinophils in the BALF increases in some cases of PCP complicated with AIDS. We emphasize that it is necessary to consider PCP when the percentage of eosinophils in the BALF increase.
Itoh
Masayuki
M
The Fifth Department of Internal Medicine, Tokyo Medical University Hospital.
Nakamura
Hiroyuki
H
Nemoto
Kenji
K
Komiyama
Manabu
M
Hatao
Hidekazu
H
Shimizudani
Naohiro
N
Adachi
Hideki
H
Kishi
Kouji
K
Oh-ishi
Shuji
S
Matsuoka
Takeshi
T
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000208:Acute Disease; D000328:Adult; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D011020:Pneumonia, Pneumocystis / Q000175:diagnosis* / Q000473:pathology; D011657:Pulmonary Eosinophilia / Q000175:diagnosis*