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doi:10.1378/chest.06-2623
(Chest. 2007; 131:1234-1237)
© 2007 American College of Chest Physicians
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Flavored Cigar Smoking Induces Acute Eosinophilic Pneumonia*

Nawar Al-Saieg, MD; Ousama Moammar, MD and Ritha Kartan, MD, FCCP

* From the Department of Internal Medicine, Western Reserve Care System/Northeastern Ohio Universities College of Medicine, Youngstown, OH.

Correspondence to: Nawar Al-Saieg, MD, Department of Internal Medicine, Western Reserve Care System, 500 Gypsy Ln, Youngstown, OH 44501; e-mail: nalsaieg{at}hotmail.com

Two cases of acute eosinophilic pneumonia (AEP) following smoking of flavored cigars were analyzed for characteristic features. None of our patients had a history of smoking flavored cigars/cigarettes in the past. One of them had never smoked, and the second patient was an ex-smoker who quit 17 years ago. Both patients presented with community-acquired pneumonia-like symptoms that did not respond to treatment with antibiotics. Their chest radiographs revealed bilateral diffuse infiltrates. The diagnosis of AEP was established based on the clinical picture, BAL that revealed an average eosinophil count > 45%, and immediate clinical improvement after introducing corticosteroids. All other possible causes were excluded during the initial workup.

Key Words: eosinophils • pneumonia • smoking






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