title: [A case of AIDS-complicated lung infection mimicking acute eosinophilic pneumonia].
abstract: 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.
authors.affiliation: The Fifth Department of Internal Medicine, Tokyo Medical University Hospital.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Itoh
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakamura
authors.forename: Kenji
authors.initials: K
authors.lastname: Nemoto
authors.forename: Manabu
authors.initials: M
authors.lastname: Komiyama
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Hatao
authors.forename: Naohiro
authors.initials: N
authors.lastname: Shimizudani
authors.forename: Hideki
authors.initials: H
authors.lastname: Adachi
authors.forename: Kouji
authors.initials: K
authors.lastname: Kishi
authors.forename: Shuji
authors.initials: S
authors.lastname: Oh-ishi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Matsuoka
mesh_terms: 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*