Chronic
eosinophilic pneumonia (CEP) is uncommon and predominantly seen in
women . More than 6% of
eosinophils in peripheral
blood and more than 25% in
bronchoalveolar lavage are diagnostic criteria.
Secondary causes of hypereosinophilic
pneumonia must be ruled out. We
report a 72-year-old
non-smoker man presenting in the
emergency room with a
history of
cough ,
fever , and moderate
dyspnea . He was not taking any medication. A
chest -
X ray showed a left lower lobe (LLL) consolidation, and was started on broad-spectrum
antibiotics with a presumptive
diagnosis of
pneumonia . There was no improvement after
therapy . A
chest CT scan showed increased LLL consolidation and new left upper lobe ground
glass opacities as well as a moderate left
pleural effusion . Flexible
bronchoscopy was performed and
bronchoalveolar lavage showed 95%
eosinophils , and had negative
cultures . No
parasites were identified. Transbronchial
biopsies demonstrated
eosinophil accumulation in alveoli and interstitium and pleural fluid was composed by 85%
eosinophils . With the
diagnosis of CEP, systemic
corticosteroids were used with favorable clinical and radiological response.