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Hypereosinophilic asthma (defined by blood eosinophils >1 G/l, especially >1.5 G/l) may occur as a primary pathology (and often difficult to treat) or as the manifestation of a hypereosinophilic disorder of determined cause (iatrogenic, parasitic, allergic bronchopulmonary aspergillosis) or idiopathic (idiopathic chronic eosinophilic pneumonia, Churg–Strauss syndrome, idiopathic hypereosinophilic syndrome).

Two cases of pulmonary eosinophilia associated with coccidioidal infections are reported. Pulmonary eosinophilia in these cases represents a hypersensitivity reaction to the fungus. Histologically, the pulmonary eosinophilia in these cases closely mimicked or appeared identical to idiopathic chronic eosinophilic pneumonia. Coccidioides immitis organisms were rare or absent in the areas of pulmonary eosinophilia. Recognition of this phenomenon is important for proper care of the patient.