Respir Case Rep. 2015; 4(2): 83-86 | DOI: 10.5505/respircase.2015.48568

INTERACTIVE CASE REPORT: Acute Eosinophilic Pneumonia due to Heroin Inhalation

Deniz Doðan¹, Nesrin Öcal¹, Ali Fuat Çiçek², Gürhan Taþkýn³, Orhan Yücel¹, Cantürk Taþçý¹, Seyfettin Gümüþ¹, Ergün Uçar¹, Ömer Deniz¹, Ergun Tozkoparan¹, Hayati Bilgiç^1
1Department of Chest Diseases, Gülhane Military Medical Academy, Ankara, Turkey
²Department of Pathology, Gülhane Military Medical Academy, Ankara, Turkey
³Department of Intensive Care Unit, Gülhane Military Medical Academy, Ankara, Turkey

Acute eosinophilic pneumonia (AEP) is a rare eosinophilic lung disease. Herein, we report a case of AEP. A 22-year-old man was admitted to our clinic with high fever, progressive dyspnea, and bruising of the fingertips. The patient had been inhaling heroin for the last two months. The arterial blood gases (room air) were as follows: SaO2: 75% and PaO2: 47mmHg. Because bilateral heterogeneous infiltrations were observed in the chest-x-ray, thorax HRCT was performed in which bilateral, diffuse, and patchy consolidations and ground-glass opacities were present. When his respiratory failure deepened, he was taken for invasive mechanical ventilation and bronchoalveolar lavage (BAL) was obtained through the endotracheal tube. BAL eosinophilia was measured over 25%. The patient was diag-nosed with AEP. Sixty mg/day prednisone therapy was started and he was extubated on the second day. Nearly complete radiological improvement was observed on the fifth day of treatment. The steroid dose was tapered.

Keywords: Acute eosinophilic pneumonia, dyspnea, heroin inhalation.

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ÝNTERAKTÝF OLGU SUNUMU: Eroin Ýnhalasyonuna Baðlý Akut Eozinofilik Pnömoni Olgusu

Deniz Doðan¹, Nesrin Öcal¹, Ali Fuat Çiçek², Gürhan Taþkýn³, Orhan Yücel¹, Cantürk Taþçý¹, Seyfettin Gümüþ¹, Ergün Uçar¹, Ömer Deniz¹, Ergun Tozkoparan¹, Hayati Bilgiç^1
1Gülhane Askeri Týp Akademisi, Göðüs Hastalýklarý Anabilim Dalý, Ankara, Türkiye
²Gülhane Askeri Týp Akademisi, Patoloji Ana Bilim Dalý, Ankara, Türkiye
³Gülhane Askeri Týp Akademisi, Yoðun Bakým Bilim Dalý, Ankara, Türkiye

Akut eozinofilik pnömoni (AEP) nadir görülen bir eozinofilik akciðer hastalýðýdýr. AEP'e örnek bir olgu paylaþýyoruz. Yüksek ateþ, ilerleyici nefes darlýðý ve parmak uçlarýnda morarma þikâyetleri ile baþvuran 22 yaþýnda erkek hasta son iki aydýr eroini inhale etmek suretiyle kullandýðýný söylemekteydi. Oda havasýnda arteryal kan gazýnda SaO2 %75, PaO2 ise 47 mmHg olarak ölçüldü. PA akciðer grafisinde bilateral, yaygýn, heterojen infiltrasyonlar izlenmesi üzerine çekilen toraks HRCT'de de bilateral, daðýnýk, yamasal buzlu cam opasiteleri ve konsolidasyon alanlarý görüldü. Hastanýn solunum yetmezliði derinleþmesi üzerine invazif mekanik ventilasyona baðlanarak endotrakeal tüp içinden bronkoalveolar lavaj (BAL) alýndý. BAL'da eozinofil %25'in üzerinde ölçüldü. Hasta mevcut bulgularý ile AEP olarak deðerlendirildi ve 60 mg/gün IV prednizolon tedavisi baþlandý. Tedavinin ikinci gününde ekstübe edilen hasta-nýn beþinci günde çekilen PA akciðer grafisinde tama yakýn düzelme izlendi. Steroid tedavisi doz azaltýlarak kesildi.

Anahtar Kelimeler: Akut eozinofilik pnömoni, eroin inhalasyonu, dispne.

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