A middle-aged individual of Ethiopian origin attended the emergency department with haemoptysis. The patient had no other significant medical problems and had not travelled for several years. The patient drank moderately and did not smoke but later admitted to chewing khat (a narcotic leaf) frequently over the past 6 months. There were no significant findings on physical examination. Renal and liver function tests and C reactive protein were within normal limits, but a peripheral blood eosinophilia was noted (2.1×109/l). Serological tests for HIV, hepatitis B and C were negative. A poorly defined opacity was seen in the right lung on …