Postoperative respiratory failure due to acute eosinophilic pneumonia |
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Authors: | R. C. St. John J. N. Allen E. R. Pacht |
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Affiliation: | (1) Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, The Ohio State University Hospitals, N 325 Means Hall 1654 Upham Drive, 43210 Columbus, Ohio, USA |
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Abstract: | A non-smoking 63-year-old man developed respiratory failure following surgical repair of a thoracoabdominal aortic aneurysm. He had severe hypoxemia and an elevated minute ventilation requiring prolonged mechanical support. Initial postoperative chest radiographs revealed new, transient, migratory infiltrates, and the patient received broad-spectrum antibiotic therapy. Chest radiographs subsequently demonstrated persistent, diffuse infiltrates, and bronchoalveolar lavage (BAL) analysis demonstrated significant eosinophilia (30%) with no evidence of infection. A diagnosis of acute eosinophilic pneumonia was made, and treatment with intravenous methylprednisolone resulted in rapid clinical improvement, and extubation. Acute eosinophilic pneumonia is not a previously recognized cause of postoperative respiratory failure and prolonged mechanical ventilation. It should be suspected in postoperative patients with unexplained diffuse lung infiltrates and acute respiratory failure. |
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Keywords: | Eosinophilic pneumonia Acute respiratory failure Postoperative |
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