A CASE FOR SERIAL EXAMINATION OF SPUTUM INFLAMMATORY CELLS

In the case reported, serial evaluation of sputum inflammatory cell co unts made it possible to identify an unusual series of events in a man with eosinophilic bronchitis, The patient initially presented with a productive cough, which did not respond to treatment with antibiotics or high-dose inhaled corticosteroids, A diagnosis of eosinophilic bron chitis was made after demonstration of intense sputum eosinophilia. Wh en inhaled corticosteroids were stopped, symptoms and sputum eosinophi lia became worse and airway hyperresponsiveness developed, Both abnorm alities were reversed by a course of prednisone, When the prednisone w as stopped the productive cough recurred but on this occasion sputum e xamination suggested a different disease process and the symptoms reso lved after a course of co-trimoxazole, The patient has subsequently re mained well on no treatment with little or no sputum eosinophilia.