Cor pulmonale: an unusual presentation of tropical eosinophilia.
Tropical pulmonary eosinophilia (TPE) is considered to be a variant of human filarial infection. The pulmonary manifestations of TPE have been well described. Extra-pulmonary features of the disease, although not commonly seen, have been reported previously. A 9-year-old Malay girl with a history of recurrent cough and wheezing was admitted because of cardiac failure. Physical examination revealed a very sick girl with tachypnoea, central cyanosis, finger clubbing, elevated jugular venous pulse, generalized crackles and rhonchi in the chest, a loud second heart sound and hepatosplenomegaly. A chest radiograph showed cardiomegaly and right pleural effusion. Laboratory investigations revealed hypochromic, microcytic anaemia with persistent blood eosinophilia (absolute eosinophil counts varied from 1.9 to 5.5 x 10(9)/1). The ELISA test for antifilarial IgG antibodies was strongly positive. She responded promptly to treatment with diethylcarbamazine. In summary, this is a patient with TPE who presented with cor pulmonale, probably due to late-stage interstitial pulmonary fibrosis. In order to prevent the long term morbidity of cardiorespiratory disability, the early signs of TPE should be recognized and the infection treated.
Quah
B S
BS
Department of Pediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Anuar
A K
AK
Rowani
M R
MR
Pennie
R A
RA
D000818:Animals; D017178:Brugia malayi / Q000302:isolation & purification; D002648:Child; D005260:Female; D006801:Humans; D011657:Pulmonary Eosinophilia / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D011660:Pulmonary Heart Disease / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome