• Xing Liu, Wangyuan Sun, Wenshu Meng, Yonglong Xiao, Ganzhu Feng, and Bin Shi.
• Department of Respiratory Medicine, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian.
• Medicine (Baltimore). 2019 Mar 1; 98 (9): e14704.

RationaleAcute eosinophilic pneumonia (AEP) is a rare pulmonary disease, which is characterized by diffuse pulmonary eosinophilia. The pathogenesis remains unknown. Here we report a patient with AEP following a recently acquired habit of smoking.Patient ConcernsA 21-year-old female presented with fever, dry cough, and acute hypoxic respiratory distress for 2 days. Chest computed tomography showed bilateral ground glass opacities, patchy nodules, and pleural effusions. Blood tests showed a gradually raised peripheral eosinophils level.DiagnosesBronchoalveolar lavage fluid revealed marked elevation of eosinophils. She was diagnosed with AEP.InterventionsSystemic methylprednisolone was immediately used for treatment.OutcomesHer clinical symptoms and chest radiographs improved promptly after treatment.LessonsCigarette smoking might be an underlying triggering factor of AEP. Diffuse alveolar infiltrates and a gradually increasing peripheral eosinophilia should raise the concern especially in recent smoking patients.

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