Acute eosinophilic pneumonia following mRNA COVID-19 vaccination: a case report
Miguel Barrio Piqueras 1 , Ana Ezponda Casajús 1 , Carmen Felgueroso Rodero 2 , Cesar Urtasun Iriarte 1 , Isberling Madeleine Di Frisco 2 , Javier Carlos Larrache 1 , Gorka Bastarrika 1 , Ana Belén Alcaide Ocaña 2
A previously healthy 37-year-old male was admitted to hospital after two days of mild fever, dyspnea, wheezing, oppressive chest pain, dry cough, palpitations and arthromyalgia that started just 8-10 h after the second dose of Pfizer-BioNTech COVID-19 vaccine.
The chest X-ray showed multilobar and coalescent alveolar opacities. Serial negative nasopharyngeal swab reverse transcriptase-polymerase chain reaction (RT-PCR) tests ruled out SARS-CoV-2 infection.
Unenhanced chest CT performed a few hours after admission revealed bilateral ground glass opacities (GGO) and consolidation with interlobular septal thickening, peribronchial cuffing, and mild bilateral pleural effusion (Fig. 1). The analysis of bronchoalveolar lavage (BAL) allowed to ruled out infection and showed differential cell count of 60.3% eosinophils.
These findings suggested an acute eosinophilic pneumonia (AEP). Blood eosinophils gradually increased during the hospitalization (0.7–4.13 109/L). Due to the spontaneous clinical improvement, the patient was discharged five days after admission.