Acute Eosinophilic Pneumonia Presenting with an Elevated Procalcitonin Level: A Rare Laboratory Finding

BACKGROUND We present the case of a 33-year-old female who was transferred to a tertiary care hospital because of acute respiratory failure. CASE REPORT History, imaging, and laboratory testing (including an elevated procalcitonin level) were consistent with a diagnosis of bacterial pneumonia. However, despite broad spectrum intravenous antibiotics, her condition worsened. Shortly after transfer to our hospital, she required intubation and mechanical ventilation. Bronchoscopy with bronchoalveolar lavage (BAL) was performed and a diagnosis of acute eosinophilic pneumonia was made. After discontinuation of antibiotics and initiation of steroids she improved quickly. CONCLUSIONS Our case highlights the importance of considering alternative diagnoses in patients who appear to have bacterial lower respiratory tract infection, even in those with elevated procalcitonin levels

Spontaneous Escherichia coli Empyema Thoracis: An Unusual Occurrence in a Non-cirrhotic, Immunocompetent Individual

Spontaneous bacterial empyema is a spontaneous infection of the pleural cavity in the absence of pneumonia, typically seen in patients with liver cirrhosis and preexisting hepatic hydrothorax. Empyema thoracis caused by Escherichia coli (E. coli) is a rare clinical finding and, in most cases, a consequence of E. coli pneumonia. Spontaneous bacterial empyema secondary to E. coli in a non-cirrhotic individual is an unusual association, rarely described in the literature. To the best of our knowledge, this is the first case of spontaneous bacterial E. coli empyema thoracis in a non-cirrhotic, immunocompetent individual with a complex medical history including pulmonary thromboembolism, oropharyngeal dysphagia, and a high aspiration risk of oropharyngeal secretions. Keywords: complex medical history; escherichia coli empyema; high aspiration risk; non-cirrhotic; oropharyngeal dysphagia; pulmonary thromboembolism; spontaneous bacterial empyema

Neutropenic Enterocolitis Complicating Induction Chemotherapy in an Acute Myeloid Leukemia Patient

Neutropenic enterocolitis is a rare inflammatory condition of the ileocecum. Clinicians should be aware of neutropenic enterocolitis in neutropenic patients with hematologic malignancies undergoing chemotherapy as it portends a poor prognosis if not diagnosed early in its course. We report a patient diagnosed with neutropenic enterocolitis within one week of receiving induction chemotherapy for acute myeloid leukemia. Keywords: acute myeloid leukemia; chemotherapy; neutropenic enterocolitis; typhilitis