Chronic eosinophilic pneumonia with endobronchial nodules: a case report.

Chronic eosinophilic pneumonia (CEP) is a rare, idiopathic condition characterized by pulmonary eosinophilic infiltration and peripheral opacities, typically responsive to corticosteroids. Tracheobronchial involvement is uncommon. We report a 44-year-old male patient presenting with clinical picture consistent with CEP with marked eosinophilia of 2.7 × 109/L. Bronchoscopy showed diffuse endobronchial nodules, which were resolved after steroid treatment. Biopsy confirmed eosinophilic infiltration. The diagnosis of CEP with endobronchial involvement was made. The patient showed rapid clinical and radiological improvement shortly after systemic corticosteroid therapy. However, relapse occurred after steroid tapering consistent with steroid dependent disease necessitating treatment with benralizumab as steroid sparing biologic therapy. This case highlights an unusual manifestation of CEP involving the tracheobronchial mucosa, which may be associated with more symptom burden and relapsing disease course, emphasizing the importance of recognizing airway involvement in eosinophilic lung diseases.