CTICasesAcute Flare of Chronic Eosinophilic Pneumonia
Imaging findings
A 59-year-old woman with a history of chronic eosinophilia, either chronic eosinophilic pneumonia or hypereosinophilic syndrome, on chronic corticosteroids presented with five days of worsening dyspnea, cough, and hemoptysis. Chest radiograph showed mass-like areas of consolidation on a background of hazy opacity, and bronchoalveolar lavage showed 55 percent eosinophils with a negative ANCA.
Key takeaways
The presentation reflects an acute flare of her known chronic eosinophilic process whenever her corticosteroids are tapered, rather than a new infection or hemorrhage, and she improved rapidly with high-dose steroids as expected. Without the known history of chronic eosinophilia, this dense, mass-like consolidation pattern would not typically be recognized as an eosinophilic flare, and the case raises the question of whether she truly has chronic eosinophilic pneumonia versus a hypereosinophilic syndrome with pulmonary involvement given her increasing multi-organ criteria.
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