Q: 21 year old male is admitted from ER with acute respiratory failure. Patient is intubated. CXR shows bilateral ARDS. You started antibiotics. There is no significant past medical history.Brother told you patient just started smoking. You decide to perform bronchoscopy. What is your suspicion?



Answer: Acute eosinophillic pneumonia

Increasing body of evidence suggest close association between new onset or even change in smoking habit and acute eosinophillic pneumonia. Suspicion should be high in yound patients presenting with acute respiratory distress. Early diagnosis is crucial as patients with AEP respond rapidly to high doses of systemic corticosteroids.



Uchiyama H, Suda T, Nakamura Y, et al. Alterations in smoking habits are associated with acute eosinophilic pneumonia. Chest. May 2008;133(5):1174-80