Chronic eosinophilic pneumonia: a cause of adult respiratory distress syndrome.

It is important that physicians not overlook the diagnosis of chronic eosinophilic pneumonia (CEP), since this disorder is readily reversible with corticosteroid therapy. Six patients with CEP were seen at our institution between 1979 and 1983. We present their clinical features, chest films, and pathologic findings, and review the literature on CEP. While most of our patients had the classic chest x-ray pattern of peripheral opacities in a nonsegmental distribution, two had atypical features with diffuse abnormalities on x-ray films. In fact, the two patients who had adult respiratory distress syndrome (ARDS), presented diagnostic difficulty and required admission to the intensive care unit. In contradistinction to the four patients with classic CEP, the two with ARDS had a delayed response to corticosteroids. Therefore, we conclude that chronic eosinophilic pneumonia is an important entity to recognize as a potentially fatal cause of the adult respiratory distress syndrome.