Acute eosinophilic pneumonia associated with antidepressant agents

Acute eosinophilic pneumonia is a severe syndrome characterized by fever, l ung infiltrates, blood eosinophilia and respiratory failure. We describe a case of acute eosinophilic pneumonia associated with clomipramine and sertr aline. A 40-year-old woman was admitted to the emergency department with 37 .9 degrees C and respiratory rate of 35 respirations per minute. Blood anal ysis showed PaO2 = 57.6 mm Hg and HCO3- = 21.7 mmol/l and 12.2 % eosinophil s. Chest X-ray showed infiltrates in both lower lobes. She was taking clomi pramine 25 mg bid for the last 4 weeks and sertraline 50 mg/day for the las t week. Other causes of acute eosinophilic pneumonia such as parasitic and fungal infections or collagen diseases were discarded. Both antidepressant were stopped and the patient became afebrile and asymptomatic. A week later the patient was discharged from hospital. Physicians should be aware of th is adverse antidepresant reaction which may result in severe pulmonary symp toms.