title: Chronic eosinophilic pneumonia presenting with ipsilateral pleural effusion: a case report.
abstract: BACKGROUND
  Chronic eosinophilic pneumonia is a rare idiopathic interstitial lung disease. The nearly pathognomonic radiographic finding is the peripheral distribution of alveolar opacities. Pleural effusions are rarely seen. We report a case of chronic eosinophilic pneumonia with transudative eosinophilic pleural effusion.
  
  
  METHODS
  A 57-year-old Hispanic woman, a nonsmoker with a history of controlled asthma, presented to the hospital with unresolving pneumonia despite three rounds of antibiotics over a 2-month period. She was later diagnosed with chronic eosinophilic pneumonia based on the presence of peripheral blood eosinophilia, the peripheral distribution of alveolar infiltrates on chest radiograph, and a lung parenchymal biopsy with infiltrates of eosinophils. Upon presentation, our patient had a right-sided moderate-sized pleural effusion. The pleural fluid profile was consistent with a transudative effusion with eosinophil predominance. Our patient responded promptly to oral corticosteroid treatment in a few days. The pulmonary infiltrates and pleural effusion subsided on a 1-month follow-up chest radiograph after starting corticosteroid treatment.
  
  
  CONCLUSIONS
  We report the first case of chronic eosinophilic pneumonia presenting with pneumonia with ipsilateral transudative eosinophilic pleural effusion. Like other cases of chronic eosinophilic pneumonia, early recognition and diagnosis is essential and prompt treatment with corticosteroids is the mainstay of therapy. Pleural effusion resolved without the further need for therapeutic thoracentesis.
authors: University of California, Davis, USA. drnarins@gmail.com.|Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, 4150 V Street, Suite 3100, Sacramento, CA, 95817, USA. drnarins@gmail.com.|VA Northern California Health Care System, 10535 Hospital Way, Mather, CA, 95655, USA. drnarins@gmail.com.|The Queen's Medical Center, Department of Internal Medicine, 1301 Punchbowl Street, Honolulu, HI, 96813, USA. drnarins@gmail.com.
authors: Narin
authors: N
authors: Sriratanaviriyakul
authors: University of California, Davis, USA.|VA Northern California Health Care System, 10535 Hospital Way, Mather, CA, 95655, USA.|Division of Hematology and Oncology, 4501 X Street, Sacramento, CA, 95817, USA.
authors: Hanh H
authors: HH
authors: La
authors: University of California, Davis, USA.|Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, 4150 V Street, Suite 3100, Sacramento, CA, 95817, USA.|VA Northern California Health Care System, 10535 Hospital Way, Mather, CA, 95655, USA.
authors: Timothy E
authors: TE
authors: Albertson
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008875:Middle Aged; D010996:Pleural Effusion / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D011657:Pulmonary Eosinophilia / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D014057:Tomography, X-Ray Computed
chemical_list: D000305:Adrenal Cortex Hormones
keywords: Chronic eosinophilic pneumonia; Pleural effusion