[Chronic eosinophilic pneumonia associated with allergy to candida and with changes in bronchoalveolar lavage fluid]

A 61-year-old woman was admitted to the hospital with the chief complaints of fever, coughing, and shortness of breath. A chest X-ray film revealed infiltrates in both upper lung fields. A specimen was obtained by transbronchial lung biopsy and chronic eosinophilic pneumonia was diagnosed. The patient' s condition improved after the start of corticosteroid therapy. A relapse occurred, and corticosteroid therapy was again successful. Because an environmental provocation test was positive, allergological examinations were done. An intradermal test for sensitivity to candida was positive, as was a test for precipitation of antibodies to candida. In addition, an inhalation provocation test with candida antigen was positive. Therefore, allergy to candida was believed to have caused this patient's symptoms. Bronchoalveolar lavage was done three times. Eosinophils predominated in the first sample, but lymphocytes predominated in the last two. This raises the possibility that chronic eosinophilic pneumonia and bronchiolitis obliterans organizing pneumonia might change into each other.