Visceral larva migrans due to Ascaris suum which presented with eosinophilic pneumonia and multiple intra-hepatic lesions with severe eosinophil infiltration--outbreak in a Japanese area other than Kyushu.
A 32-year-old man presented with the chief complaint of severe cough. Examination of peripheral blood showed a marked increase in eosinophils. Chest CT demonstrated multiple ground glass opacities in both lungs. Bronchoalveolar lavage showed abundant eosinophils. Abdominal CT demonstrated multiple low attenuation areas in the liver. Liver biopsy with ultrasonography revealed severe eosinophil infiltrations around the portal veins. Serologically, a multi-dot enzyme linked immunosorbent assay (DOT-ELISA) and ELISA inhibition test using microtiter plates were positive for Ascaris suum. Thus, visceral larva migrans due to Ascaris suum was diagnosed. Outbreaks of this disease in Japan have previously been confined to the Kyushu area. The present case which occurred outside that area, illustrates the importance of constant attention to the epidemiology of this disease.
Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute.
Ayako
A
Sakakibara
Kenji
K
Baba
Sayaka
S
Niwa
Takeo
T
Yagi
Hideo
H
Wakayama
Kazuhito
K
Yoshida
Tadashi
T
Kobayashi
Takio
T
Yokoi
Kazuo
K
Hara
Makoto
M
Itoh
Eisaku
E
Kimura
D000328:Adult; D000383:Agriculture / Q000379:methods; D015766:Albendazole / Q000627:therapeutic use; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D001196:Ascariasis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D017165:Ascaris suum; D001992:Bronchoalveolar Lavage Fluid; D004032:Diet / Q000009:adverse effects; D004797:Enzyme-Linked Immunosorbent Assay; D004802:Eosinophilia / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007816:Larva Migrans, Visceral / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D008109:Liver Diseases, Parasitic / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D008297:Male; D011657:Pulmonary Eosinophilia / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D014057:Tomography, X-Ray Computed
D000871:Anthelmintics; D015766:Albendazole