Tropical pulmonary eosinophilia in a patient undergoing open heart surgery.

A 35 years old male living in Jamalpur district of Bangladesh working as a shopkeeper presented with dyspnea, fatigue, occasional fever and cough for two years. He did not give any history of hemoptysis or weight loss. He was smoker and non-alcoholic. He had a soft systolic murmur over pulmonary area and wide fixed splitting of the second heart sound. An Atrial septal defect (ASD) was detected by echocardiography. The patient had high circulating eosinophil count and Complement Fixation Test for filarial antibody revealed positive result. Moreover the patient's response to drug Diethylcarbamazime indicated suspected tropical pulmonary eosinophilia with Atrial Septal Defect.

Eosinophilic pneumonia as an initial manifestation of rheumatoid arthritis.

Rheumatoid arthritis is a systemic disease that may have pulmonary manifestations. We describe a case of eosinophilic pneumonia as the primary presentation of rheumatoid arthritis. While several cases of acute and chronic eosinophilic pneumonia have been reported in patients with preexisting rheumatoid arthritis, this is the first case reported in which the eosinophilic lung disease was the initial manifestation of systemic rheumatoid arthritis.

Recurrence of Langerhans' cell granulomatosis following lung transplantation.

A case is presented of pulmonary Langerhans' cell granulomatosis which recurred following lung transplantation and responded to cyclophosphamide. This suggests that the primary abnormality in this condition lies in the Langerhans' cell or precursor dendritic cell.

[Anesthesia management for a patient with pulmonary eosinophilic granuloma associated with bilateral pneumothorax--general anesthesia with positive pressure ventilation].

Pulmonary eosinophilic granuloma (PEG) is a rare fibroinflammatory disorder and is characterized by a mixed interstitial infiltrate of eosinophils, lymphocytes and Langerhans cells. We experienced anesthetic management for a patient with PEG associated with bilateral pneumothorax. Anesthesia was maintained with epidural anesthesia and general anesthesia using positive pressure ventilation. At first we ventilated with a low airway pressure, but recognized an increase in endtidal CO2. Then we switched to a high airway pressure (= 22 cmH2O) and decreased the concentration of carbon dioxide. No new air leaks were observed by ventilating with the high airway pressure. It was concluded that in anesthetic management for PEG we must be careful about the airway pressure during operation.

Angeitis alérgica granulomatosa

Presentamos el caso de una mujer de 38 años con asma, eosinofilia periférica, sinusitis y opacidades interticiales difusas, bilaterales y fugaces en la radiografía de tórax. El procedimiento diagnóstico fue biopsia pulmonar a cielo abierto donde se encontró una vasculitis eosinofilica características del Síndrome de Churg-Strauss. Comentamos los principales hallazgos clínicos, radiológicos e histopatológicos.

[A case of pulmonary aspergillosis presenting pulmonary bulla and eosinophilic pneumonia].

A rare case of a 25-year-old man with pulmonary aspergillosis is reported. Pulmonary bulla and eosinophilic pneumonia in the right upper lobe were diagnosed by chest roentgenogram and transbronchial lung biopsy. Because the patient developed infective bullae during steroid therapy, we performed transcutaneous thoracic drainage and right upper lobectomy. The resected lung tissue contained numerous hyphae of Aspergillus. Around the hyphae of Aspergillus, granulomatous reaction and eosinophilic infiltration were observed. Antibodies against Aspergillus were detected in the serum of the patient. The number of peripheral blood eosinophils decreased after right upper lobectomy. These findings suggest that pulmonary bullae and eosinophilic pneumonia may be a rare manifestation of pulmonary aspergillosis.