Correct!
2. Chronic eosinophilic pneumonia
The mild peripheral eosinophilia, pulmonary parenchymal eosinophils, and chronic, recurrent, migratory pulmonary opacities are all most consistent with chronic eosinophilic pneumonia. Coccidioidomycosis is a prominent consideration for any patient from an endemic region with a respiratory illness, and can be associated with pulmonary eosinophilia, but repeatedly negative serological testing is unusual in the context of recent infection, and the organism was not identified at tissue sampling. Vasculitis is not a consideration as rheumatologic testing was negative, no pulmonary hemorrhage was detected at bronchoscopy or histopathological sampling, and no evidence of perivascular inflammation was present at pulmonary tissue sampling. While acute eosinophilic pneumonia also produces pulmonary eosinophilia, this disorder is less commonly associated with peripheral eosinophilia and typically patients with acute eosinophilic pneumonia have a more abrupt onset of a severe pulmonary illness rather than the chronic, relapsing course and mild illness displayed by this patient.
Diagnosis: Chronic eosinophilic pneumonia
References