If sputum contains mostly eosinophils and mucous casts, what condition is likely present?

When sputum analysis reveals a predominance of eosinophils and the presence of mucous casts, it is suggestive of asthma. This condition is characterized by airway inflammation and hyperresponsiveness, which often leads to the production of eosinophils in response to various triggers, such as allergens or irritants. In asthma, the airway hyperreactivity causes bronchoconstriction and increased mucus production, resulting in the formation of mucous casts that can be seen in the sputum.

In contrast, chronic bronchitis typically presents with a different inflammatory profile, often dominated by neutrophils rather than eosinophils, and is characterized by chronic productive cough and sputum production without the specific eosinophilic response.

Pneumonia usually features a neutrophilic response and does not typically involve eosinophils or mucous casts prominently. Lastly, bronchiectasis can also lead to mucus production and may involve various inflammatory cells, but eosinophilia specifically points more towards asthma rather than this condition.

Thus, the combination of eosinophils and mucous casts in sputum strongly aligns with the pathophysiology of asthma.