Abstract
Blood and/or tissue eosinophilia, along with respiratory symptoms and polymorphic thoracic radiological abnormalities, can be indicative of various pathological conditions. We present the case of a 43-year-old male patient, smoker, known with aspirin intolerance and chronic polypous rhinosinusitis, who presented to the pulmonology service for a productive cough with mucous expectoration, wheezing and skin lesions on the chest and upper limbs for about 2 months. Initial clinical evaluation revealed mild obstructive ventilatory dysfunction. Chest computer tomography (CT) scans showed pseudonodular pulmonary condensations with ground-glass opacities and interlobular septal thickening. The patient also displayed peripheral eosinophilia and eosinophils in bronchoalveolar lavage fluid. Based on the clinical history and laboratory results, the primary diagnostic hypothesis was Churg-Strauss vasculitis. The imaging lesions of alveolo-interstitial type (in the context of the detection of a positive GeneXpert for Mycobacterium tuberculosis) supported a diagnosis of infiltrative-nodular tuberculosis, which led to the initiation of antituberculosis therapy alongside corticosteroid treatment, resulting in favourable clinical and imaging outcomes.