Full blood examination demonstrated an eosinophilia 20x the upper limits of normal. Parasitic and fungal screens were negative. No recent antibiotic use. The patient proceeded to bronchoscopy: 

Specimen Type: Broncho-alveolar Lavage 

MACROSCOPIC DESCRIPTION: 10ml cloudy colourless fluid.

MICROSCOPIC DESCRIPTION: The smears contain scattered alveolar macrophages in a background of abundant eosinophils. No fungal elements demonstrated on Grocott stain. No features present to suggest alveolar proteinosis. No malignant cells are identified.


  • Alveolar macrophages 27% (83-94%)
  • Lymphocytes 02% (5-16%)
  • Neutrophils 0% (1-6%)
  • Eosinophils 71% (0-1%)
  • Bronchial cells 0% (0-5%)

DIAGNOSIS: Broncho-alveolar Lavage: Marked eosinophilia. Negative for malignancy.