CBC count reveals a WBC count of 7.7 × 103/μL, with a differential of 57% neutrophils, 22% lymphocytes, 8% monocytes, and 13% eosinophils. His hemoglobin is 16.1, hematocrit is 47.6, and platelets are 288 × 103/μL. Other pertinent laboratory values include the following: erythrocyte sedimentation rate, 10 mm/h; C-reactive protein, 0.08 mg/L; antinuclear antibody, 1:40; rheumatoid factor < 20; IgE, 1,767 ng/mL (normal reference value, 0–100); IgG, 1,710 ng/mL (normal reference value, 700–1,620); and IgM, 66 ng/mL (normal reference value, 44–266). His HIV serum test result is negative, and his angiotensin-converting enzyme level, coccidioides antibodies, cryptococcal antigen, aspergillus, blastomyces, and histoplasma antibodies, chlamydia polymerase chain reaction, mycoplasma polymerase chain reaction, and allergic bronchopulmonary aspergillosis skin testing are unrevealing. His tuberculin skin test result is negative. A chest radiograph (Fig 1
) and a representative section from chest CT (Fig 2
) are shown.