Correct!
5. Acute eosinophilic pneumonia

Viral community-acquired pneumonia and hypersensitivity pneumonitis are both unlikely causes of this patient’s respiratory failure as no data to support either condition was found. Chronic eosinophilic pneumonia most often presents as a relapsing illness rather than abrupt onset respiratory failure, and pulmonary opacities in this disease frequently show a peripheral or frankly subpleural distribution- unlike the clinical presentation and imaging findings in this patient. No data supporting the diagnosis of pulmonary vasculitis were found. The abrupt onset of respiratory failure in an otherwise young, healthy patient found to have a markedly elevated eosinophilic count on bronchoalveolar lavage, combined with the patient’s rapid recovery following corticosteroid therapy, is consistent with acute eosinophilic pneumonia.)

Diagnosis: Acute eosinophilic pneumonia.

Which of the following regarding acute eosinophilic pneumonia is true?

1. Most patients have a prior history of asthma
2. Most patients have an elevated peripheral eosinophil count
3. Lung eosinophilia (bronchoalveolar lavage differential cell count ≥ 25% eosinophils or predominance of eosinophils on open lung biopsy) is typical
4. Imaging studies characteristically show multifocal lung opacities, some of which will show a characteristic peripheral, subpleural distribution
5. Clinical relapses following corticosteroid therapy are common

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