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Eosinophilic pneumonias are characterized by accumulation of eosinophils in alveolar spaces, interstitium, or both. Peripheral eosinophilia is common. Causes include: infections (especially helminthic); drug-induced pneumonitis (e.g., antibiotics, phenytoin, l-tryptophan); inhaled toxins (e.g., cocaine); systemic disease (e.g., Churg Strauss syndrome); allergic bronchopulmonary aspergillosis. Diagnosis based on opacities on chest X-ray and eosinophilia in peripheral blood, bronchoalveolar lavage fluid, or lung biopsy. Chronic eosinophilic pneumonia has unknown etiology. Suspected to be allergic diathesis. Fulminant illness with cough, fever, weight loss, accompanied by or preceded by asthma in 50% of cases. Acute eosinophilic pneumonia also has unknown etiology but may be acute hypersensitivity reaction to unidentified inhaled antigen. Characterized by acute febrile illness with cough, dyspnea, malaise, myalgias, night sweats, and pleuritic chest pain. Loeffler\'s syndrome may be caused by parasitic infections, especially Ascaris lumbricoides, but identifiable agent often not found. Characterized by absent or mild respiratory symptoms, fleeting migratory pulmonary opacities, and peripheral blood eosinophilia.
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