CASE PRESENTATION: 62 year old women non-smoker presented with three weeks of dyspnea and productive cough. This was associated with anorexia and weight loss. She failed azithromycin therapy. No past medical history or allergies. Physical exam showed diffuse rhonchi throughout the left side. No clubbing, rash or adenopathy. There was peripheral eosinophilia (32%) without leucocytosis. Autoimmune panel (ANCA, Scl-70, ANA, RF), aspergillus antigen and cultures were negative. IgE elevated at 713 IU/ ml. Chest radiograph showed left lung consolidation with clear right lung (Figure 1). CT chest showed extensive left sided consolidation and reactive lymph nodes. Bronchoscopy showed erythema with notable secretions. Bronchoalveolar lavage (BAL) showed 40% eosinophils and 18% lymphocytes. CEP was diagnosed on the basis of peripheral eosinophilia and high eosinophil count in BAL.