Acute Eosinophilic Pneumonia in a Teenager as a Result of Smoking : Importance of Differential Diagnosis

A 16-year-old boy presented to our hospital with a 2-day history of acute onset of cough and dyspnea. He denied chest pain, sputum, fever and chills. Past medical history was unremarkable. He reported no history of allergy, medications, inhalational of volatile liquids or gasses, illicit drugs, or smoking. / On examination, blood pressure was 120 60 mmHg, pulse of 142 bpm, respiratory rate of 24 per minute, and body temperature of 38.5 degrees Celsius. Lateinspiratory fine crackles were audible on bilateral lung fields. Heart sounds were regular and there were no murmur, gallops, or rubs. Oxygen saturation on breathing room air revealed 93%. Chest roentgenogram and computed tomographic scan showed ground-glass infiltrates in peripheral lung zones mainly in the right upper lobe of the lung (Figures A, B, C). Laboratory data showed leukocytosis without eosinophilia(Table 1). Both urine Pneumococcal and Legionella antigens were negative. Serum antibodies against Mycoplasma pneumoniae and Chlamydophila pneumoniae were sent. Based on the findings of the imaging study, acute eosinophilic pneumonia(AEP)was suspected and General Medicine 2013, vol. 14, no. 1, p. 64-66.