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Acute eosinophilic pneumonia — SCE Acute Medicine MCQ

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HardAcute Respiratory PresentationsAcute eosinophilic pneumoniaSCE Acute Medicine

A 34-year-old man is assessed on the acute medical unit. He has acute febrile respiratory failure after starting to vape heavily. CT chest shows diffuse ground-glass opacities and bronchoalveolar lavage later shows eosinophilia. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most likely diagnosis?

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Correct answer: B — Acute eosinophilic pneumonia

Acute eosinophilic pneumonia is the best answer because acute hypoxaemia with diffuse infiltrates and airway exposure is compatible with acute eosinophilic pneumonia. Status epilepticus is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Peripheral eosinophilia may be absent early, so BAL can be decisive.

Reference: https://www.brit-thoracic.org.uk/quality-improvement/guidelines/#acute-medicine-order-69-1