title: Eosinophilic pneumonia associated with concomitant cigarette and marijuana smoking.
abstract: A 29-year-old Caucasian man presented for the evaluation of a new onset of shortness of breath associated with cough and wheeze for 1 day. The history was significant for a recent travel of 20 h duration to Houston, a new onset of cigarette smoking for 2 weeks and marijuana smoking. The patient was afebrile and did not have any leg swelling; initial diagnosis of community-acquired pneumonia was made and the patient was started on antibiotics. Despite being on antibiotics, his medical condition continued to deteriorate and extensive diagnostic workup for infectious and autoimmune aetiology including bronchoalveolar lavage was completed and was inconclusive. Ultimately, the patient underwent video-assisted thoracoscopic lung biopsy which led to the diagnosis of acute eosinophilic pneumonia. Steroids were started with a good treatment response. The patient was discharged on a tapering dose of steroids; a follow-up chest x ray at 6 weeks was within normal limits.
authors: Department of Internal Medicine, Saint Joseph Hospital, Chicago, Illinois, USA.
authors: Aparna
authors: A
authors: Natarajan
authors: Payal
authors: P
authors: Shah
authors: Aibek E
authors: AE
authors: Mirrakhimov
authors: Nasir
authors: N
authors: Hussain
mesh_terms: D000208:Acute Disease; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001706:Biopsy; D004804:Eosinophils / Q000378:metabolism*; D006801:Humans; D008168:Lung / Q000473:pathology*; D008297:Male; D008385:Marijuana Smoking / Q000009:adverse effects*; D011657:Pulmonary Eosinophilia / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D012907:Smoking / Q000009:adverse effects*; D013256:Steroids / Q000627:therapeutic use; D013906:Thoracoscopy; D014195:Travel
chemical_list: D000900:Anti-Bacterial Agents; D013256:Steroids
references: Radiology. 1997 Jun;203(3):715-9
references: 9169693
references: Medicine (Baltimore). 1996 Nov;75(6):334-42
references: 8982150
references: Clin Sci (Lond). 1995 Apr;88(4):485-9
references: 7540525
references: Pediatr Pulmonol. 2010 Dec;45(12):1246-9
references: 20812251
references: Am J Respir Crit Care Med. 1997 Jan;155(1):296-302
references: 9001328
references: JAMA. 2004 Dec 22;292(24):2997-3005
references: 15613668
references: Intern Med. 2000 Jan;39(1):66-8
references: 10674853
references: Am J Respir Crit Care Med. 1999 Oct;160(4):1079-100
references: 10508792
references: Arch Intern Med. 1992 Sep;152(9):1913-9
references: 1520060
references: Chest. 2008 May;133(5):1174-80
references: 18263675
references: Semin Respir Crit Care Med. 2006 Apr;27(2):142-7
references: 16612765
references: Am J Respir Crit Care Med. 2002 Nov 1;166(9):1235-9
references: 12403693