Pulmonary infiltrates with eosinophilia syndromes in children

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.