Eosinophilic Bronchitis Case


A 43-year-old woman presented with an 8-month history of progressively worsening nonproductive cough. She had been treated with antibiotic agents for presumed bronchitis, but her cough continued to worsen. Her vital signs were normal, the pulmonary examination was notable for wheezing in both lungs, and the white-cell count, including the absolute number of eosinophils, was normal. Results of pulmonary-function tests suggested an obstructive defect that did not respond to bronchodilators. Bronchoscopy revealed diffuse nodules in the tracheobronchial mucosa (Panel A). Biopsy of a nodule revealed eosinophilic infiltration of the bronchial mucosa. There was no evidence of tumor, infection, vasculitis, or granulomas. The patient received a diagnosis of eosinophilic bronchitis. Patients with eosinophilic bronchitis usually have normal results on spirometry, but diffuse nodules in the tracheobronchial mucosa cause obstruction that does not respond to bronchodilators. The patient was treated with systemic glucocorticoids and inhaled budesonide for 1 month. At 1 month after the start of therapy, follow-up bronchoscopy revealed a considerable decrease in the size of the nodules in the tracheobronchial mucosa (Panel B), repeat pulmonary-function tests revealed resolution of the obstructive defect, and the patient’s clinical symptoms had resolved completely. Because small nodules were still visible, the patient received inhaled budesonide for 2 additional months, after which the mucosal nodules in the trachea were no longer present. At follow-up 6 months after the start of therapy, the clinical symptoms had not recurred.

New European HTN Guidelines Hit Hard With Initial Therapy, Keep ‘High-Normal’ Label

he new European guidelines for diagnosing and managing arterial hypertension maintain the previous classification system based on blood pressure  (BP) levels but recommends a harder-hitting initial treatment approach compared to the previous version, released in 2013. The 2018 European Society of Cardiology (ESC) and European Society of Hypertension (ESH) guidelines document …

Splenic Abscess Treatment & Management

Once the diagnosis of a splenic abscess has been made, the patient must be admitted to the hospital and treated. Treatment depends on the patient’s overall condition, comorbidities, and primary disorder (if any), as well as the size and topography of the abscess. [22] Empiric broad-spectrum antibiotic therapy has a primary …

How to Use Condoms Safely

  If you’re looking for protection against pregnancy and sexually transmitted infections (STIs) without a prescription, condoms may be a good option to explore. They’re discrete, relatively inexpensive, and don’t involve any synthetic hormones. Condoms are also readily available at your nearest convenience or drug store. What are the safest …

Show Buttons
Hide Buttons