PHOTOGRAPHIC NEGATIVE OF PULMONARY EDEMA. DIFFERENTIATING CHRONIC EOSINOPHILIC PNEUMONIA FROM CHRONIC HYPERSENSITIVITY PNEUMONITIS.

A 60 years old diabetic and hypertensive lady presented with exertional dyspnea and dry cough of one year duration. Respiratory evaluation revealed bilateral coarse crackles, SpO2 was 96 % and her spirometry had restrictive abnormality. High resolution computerised tomography (HRCT) chest was consistent with patchy ground glass and dense opacities predominantly involving peripheral and lower lung zones (photographic negative of pulmonary edema) and her BAL eosinophilia (41%) in the presence of clinical and radiological abnormalities was diagnostic of chronic eosinophilic pneumonia. She showed good response to oral prednisolone treatment. Key words: Bronchoalveolar lavage, chronic eosinophilic pneumonia, peripheral alveolar infiltrates, pulmonary edema, transbronchial biopsy