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== Diagnosis ==
== Diagnosis ==
Eosinophilic pneumonia is diagnosed in one of three circumstances: when a [[complete blood count]] reveals increased eosinophils and a chest [[x-ray]] or [[computed tomography]] (CT) identifies abnormalities in the lung, when a [[biopsy]] identifies increased eosinophils in lung tissue, or when increased eosinophils are found in fluid obtained by a [[bronchoscopy]] (bronchoalveolar lavage (BAL) fluid). Association with medication or cancer is usually apparent after review of a person's medical history. Specific parasitic infections are diagnosed after examining a person's exposure to common parasites and performing laboratory tests to look for likely causes. If no underlying cause is found, a diagnosis of AEP or CEP is made based upon the following criteria. AEP is most likely with respiratory failure after an acute febrile illness of usually less than one week, changes in multiple areas and fluid in the [[pleural cavity|area surrounding the lungs]] on a chest x-ray, and greater than 25% eosinophils on a BAL. Other typical laboratory abnormalities include an elevated [[white blood cell]] count, [[erythrocyte sedimentation rate]], and [[immunoglobulin E]] level. [[spirometry|Pulmonary function testing]] usually reveals a restrictive process with reduced [[diffusion capacity]] for carbon monoxide. CEP is most likely when the symptoms have been present for more than a month. Laboratory tests typical for CEP include increased blood eosinophils, a high erythrocyte sedimentation rate, [[iron deficiency anemia]], and increased [[platelets]]. A chest x-ray can show abnormalities anywhere, but the most specific finding is increased shadow in the periphery of the lung, away from the heart.
'''Diagnostic criteria'''
 
A confident diagnosis of AEP can usually be made without a lung biopsy in patients who meet the following criteria [7,8,58,62]:
 
●A febrile illness of short duration (one month or less, but often less than one week)
 
●Hypoxemic respiratory failure (eg, pulse oxygen saturation [SpO<sub>2</sub>] <90 percent on room air or arterial oxygen tension [PaO<sub>2</sub>] <60 mmHg)
 
●Diffuse pulmonary opacities on chest radiograph
 
●BAL differential cell count showing eosinophilia >25 percent
 
●Absence of known causes of eosinophilic pneumonia, including drugs, infections, asthma, or atopic disease (table 1) (see "Causes of pulmonary eosinophilia")


==References==
==References==
{{reflist|2}}
{{reflist|2}}


[[Category:Pulmonology]]
[[Category:Pulmonology]]

Revision as of 19:59, 9 February 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Priyamvada Singh, M.D. [2]

Overview

Diagnosis

Diagnostic criteria

A confident diagnosis of AEP can usually be made without a lung biopsy in patients who meet the following criteria [7,8,58,62]:

●A febrile illness of short duration (one month or less, but often less than one week)

●Hypoxemic respiratory failure (eg, pulse oxygen saturation [SpO2] <90 percent on room air or arterial oxygen tension [PaO2] <60 mmHg)

●Diffuse pulmonary opacities on chest radiograph

●BAL differential cell count showing eosinophilia >25 percent

●Absence of known causes of eosinophilic pneumonia, including drugs, infections, asthma, or atopic disease (table 1) (see "Causes of pulmonary eosinophilia")

References


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