Presentation
Chronic dry cough, low grade fever and asthma for ten years.
Patient Data
There are multiple interstitial and intralobular patchy foci of ground glass and alveolar consolidations in the lungs more in the periphery of the lungs and large size in the upper lobes. Mild bilateral pleural fluid and a few mediastinal lymph nodes SAD up to 8mm are also noted.
Case Discussion
The shape and distribution of consolidations in the lungs along with the long-standing history of asthma, eosinophilia, and ANCA positive on the blood smear of the patient, as based on MDM discussion, were all more compatible with eosinophilic granulomatosis with polyangiitis (formerly called Churg-Strauss syndrome), which is a rare entity of small and medium-sized vessel granulomatosis vasculitis the ANCA-associated vasculitis that is more seen in asthma with eosinophilia. Fungal infections and eosinophilic pneumonia are the main differential diagnoses.
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