Pulmonary infiltrates with eosinophilia (PIE) are a group of heterogeneous
disorders having the common findings of lung disease and eosinophilia in th
e peripheral blood, bronchoalveolar lavage fluid, or pulmonary interstitium
. Eleven cases of PIE syndromes were identified through a retrospective and
prospective chart review: drug-induced (2), acute eosinophilic pneumonia (
3), infant pulmonary eosinophilia (2), parasite-induced (2), Churg-Strauss
syndrome (1), and atypical chronic PIE (1). Patient demographics, clinical
presentation, and disease severity varied considerably among groups. Therap
eutic interventions included bronchodilators (10), oxygen (7), corticostero
ids (9), and mechanical ventilation (3). A single patient with acute eosino
philic pneumonia died. Our experience suggests that PIE syndromes are rare
in childhood and that clinical presentation can vary widely. Because of the
potential for significant morbidity and mortality, aggressive diagnostic e
valuations are warranted, particularly in children with respiratory failure
of unknown etiology.