Background:
Acute eosinophilic pneumonia (AEP) is an acute febrile disease with good prognosis. It is often manifested as cough, dyspnea and fever, and sometimes may also as myalgia. However, there are no reports of AEP with sepsis-like symptoms of arthralgia, joint stiffness, lymph node enlargement, transient rashes and abnormal liver function in the literature.
Case summary:
A male patient with AEP was admitted to our hospital. He presented with fever, cough, arthralgia and joint stiffness, and also had transient rashes, lymph node enlargement and mild abnormal liver function. The counts of white blood cells and eosinophils were increased in peripheral blood. It seemed like sepsis, but his percutaneous lung biopsy suggested eosinophil inflammation, which had a good response to corticosteroids instead of antibiotics.
Discussion:
AEP is easily misdiagnosed as bacterial pneumonia with sepsis when it presents with lung infiltration on CT and atypical manifestations such as arthralgia, joint stiffness, lymph node enlargement, transient rashes and abnormal liver function. In this case, if a lot more antibiotics do not work, some of possible diseases including AEP may be considered. Increased eosinophils in peripheral blood and lung biopsy are helpful for the diagnosis of the disease.