CHEST Guidelines-A-Man-in-His-20s-With-Diffuse-Lung-Opacities-and-A

A-Man-in-His-20s-With-Diffuse-Lung-Opacities-and-A

Pdf Summary

The case study revolves around a man in his 20s who presented with acute respiratory symptoms and was eventually diagnosed with acute eosinophilic pneumonia (AEP) after smoking hookah. Initially, the patient experienced shortness of breath, fevers, chills, night sweats, and a productive cough. He had a history of recent hookah use after having lived in Saudi Arabia. Upon examination, his symptoms included high fever, tachycardia, and normal oxygen levels without accessory muscle use. Lung examination revealed bilateral bronchial sounds with coarse crackles.<br /><br />Laboratory tests showed leukocytosis, especially neutrophils, with normal serum chemistry. Imaging revealed mixed interstitial and airspace opacities, which progressively worsened. Additionally, a chest CT indicated extensive consolidation and thoracic adenopathy but no infections were confirmed through various tests.<br /><br />The diagnosis of AEP was confirmed through bronchoscopy, which showed 78% eosinophils in bronchoalveolar lavage fluid. AEP is a rare condition characterized by a sudden accumulation of eosinophils in the lungs, often lacking peripheral eosinophilia, and typically responding well to corticosteroids.<br /><br />Hookah smoking, increasingly popular among youths, can lead to health issues similar to those caused by cigarette smoking. Hookah produces significant tobacco smoke and toxins, leading to both acute and chronic health effects, such as respiratory and inflammatory changes. In this case, hookah use was linked to the development of AEP, although the precise mechanism remains poorly understood. <br /><br />Prompt recognition and treatment with corticosteroids can prevent progression to severe respiratory failure. Chronic effects of hookah may include lung function decline and increased COPD prevalence. The patient's AEP progressed to require high-level intervention, but he was successfully treated and discharged after a week. This case highlights the need for awareness of the potential pulmonary dangers of hookah smoking.

Keywords

acute eosinophilic pneumonia

hookah smoking

respiratory symptoms

bronchoscopy

corticosteroids

eosinophils

lung function

Saudi Arabia

chest CT

youth health risks