Acute eosinophilic pneumonia associated with antidepressant agents

Acute eosinophilic pneumonia is a severe syndrome characterized by fever, lung infiltrates, blood eosinophilia and respiratory failure. We describe a case of acute eosinophilic pneumonia associated with clomipramine and sertraline. A 40-year-old woman was admitted to the emergency department with 37.9 degrees C and respiratory rate of 35 respirations per minute. Blood analysis showed PaO2 = 57.6 mm Hg and HCO3- = 21.7 mmol/l and 12.2 % eosinophils. Chest X-ray showed infiltrates in both lower lobes. She was taking clomipramine 25 mg bid for the last 4 weeks and sertraline 50 mg/day for the last week. Other causes of acute eosinophilic pneumonia such as parasitic and fungal infections or collagen diseases were discarded. Both antidepressant were stopped and the patient became afebrile and asymptomatic. A week later the patient was discharged from hospital. Physicians should be aware of this adverse antidepresant reaction which may result in severe pulmonary symptoms.