Chronic eosinophilic pneumonia: A case report and review of the literature

Objective: We introduce one case of chronic eosinophilic pneumonia (CEP) and review the literature nearly 10 years in order to improve the understanding of this rare disease. Methods: A case of CEP diagnosed by transbronchial lung biopsy with clinical and follow-up data was analyzed and its clinical features, diagnosis and treatment combined with the literature were discussed. Result: CEP is a chronic pulmonary eosinophilic inflammation with unknown etiology, characterized by history of allergic disease, cough, sputum, but often breathlessness and wheezing;eosinophil in peripheral blood and/or sputum and/or bronchoalveolar lavage fluid significantly increased;chest X-ray showed progressively peripheral non-segment distribution of high-density infiltrates, often called “reversed pulmonary edema sign”;Pathology showed eosinophil infiltration in lung interstitial, bronchial submucosal and excessive eosinophil exudation in alveolar. Oral corticosteroids had a good response, but easy to relapse. Conclusions: Eosinophil count of bronchoalveolar lavage or lung biopsy can confirm the diagnosis of CEP timely in suspected patients. Bronchoscope can play an important role in assisting diagnosis and improving symptoms.

Impact of inhaled corticosteroid use on elderly chronic pulmonary disease patients with community acquired pneumonia

To the Editor:With an aging global population,the incidences of community-acquired pneumonia(CAP)and chronic obstructive pulmonary disease(COPD)have signicantly increased.[1]Previous studies have conrmed that COPD and asthma are independently associated with the prevalence of CAP.The use of inhaled corticosteroid(ICS),the cornerstone of treatment for asthma,COPD with frequent acute exacerbations,and asthma-COPD overlap(ACO)may induce changes in the local lung microbiome and abnormal lung immunity,ultimately,causing a signicantly increased risk of pneumonia.However,in cases of pneumonia,the effect of the use of ICS on CAP mortality remains controversial.While data from one study favored the prior use of ICS,which was associated with a signicantly lower short-term mortality rate,[2]other studies have identied no impact on mortality.To date,data on the impact of the use of ICS on mortality,prehospitalization or during hospitalization,are scarce,particularly in the older population.Therefore,this multicenter,retrospective study explored the association between the use of ICS during hospitalization and short-term mortality in older patients with CAP and those with chronic pulmonary disease(CPD).

Mixed invasive pulmonary Mucor and Aspergillus infection:a case report and literature review

To the Editor:Invasive pulmonary mucormycosis(IPM)is a rare but life-threatening opportunistic fungal disease with a high mortality rate of 40%to 80%.[1]Although IPM accounts for approximately 9.2%of all mucormycosis cases,it has the highest mortality rate(66.6%).A definitive diagnosis of IPM depends on the histopathological findings,regardless of culture results of the respiratory tract specimens or lung tissues.