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Pulmonary and Critical Care Pearls |

Fevers, Weight Loss, and Bilateral Peripheral Infiltrates in a Young Man*

Frances Eun-Hyung Lee, MD; Cynthia F. Caracta, MD; Alan Fine, MD; John L. Berk, MD
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*From the Pulmonary Center, Boston University School of Medicine, Boston, MA.



Chest. 1999;115(4):1181-1183. doi:10.1378/chest.115.4.1181
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A 28-year-old man with a remote history of snorting cocaine presented with a 3-month history of fevers, nightsweats, weight loss, and cough. Similar symptoms had occurred 1.5 years earlier. At that time, the appearance of the chest radiograph (Fig 1 ), borderline peripheral eosinophilia (total eosinophil count of 300/mm3), and negative sputum and blood cultures prompted the diagnosis of chronic eosinophilic pneumonia (CEP). The symptoms and lung opacities markedly improved within 2 weeks of initiating prednisone treatment at 60 mg qd. Three months later, the patient stopped taking steroids and was lost to follow-up. He denied using illicit drugs between presentations.

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