[Case report: Löffler's syndrome due to Ascaris lumbricoides mimicking acute bacterial community--acquired pneumonia].
In this study we present a patient with Loeffler's syndrome caused by Ascaris lumbricoides who presented with the clinical findings of community-acquired pneumonia (CAP). Our patient, who was twenty-five years old, and who had had symptoms such as coughing, expectorating, dyspnea and fever for approximately ten days, was hospitalized. We auscultated polyphonic rhonchuses at the both hemithoraxes. A chest X-ray revealed bilateral lower zone patch consolidation. Acute bacterial community acquired pneumonia (CAP) was diagnosed due to these findings and empirical antibiotic treatment was begun. Repeated sputum Gram stains were negative, and both sputum and blood cultures were sterile. A sputum smear was negative for acid-fast bacilli. The patient's fever and respiratory complaint did not respond to the empirical antibiotics therapy. During the course of advanced investigations, we measured peripheric eosinophilia, and high levels of total Eo and total IgE, and observed Ascaris lumbricoides eggs during stool examination. The patient was given a diagnosis of Loeffler's syndrome. Thereupon the patient was treated successfully with one dose of albendazol 400 mg. In conclusion, we suggest that Loeffler's syndrome must be considered early in the differential diagnosis for CAP when peripheric eosinophilia is seen in patients if they live in an endemic area for parasitic disease.
Gülhane Askeri Tip Akademisi Haydarpaşa Eğitim Hastanesi, Enfeksiyon Hastaliklari ve Klinik Mikrobiyoloji Servisi, Istanbul, Turkey. draliacar@yahoo.com
Ali
A
Acar
Oral
O
Oncül
Saban
S
Cavuşlu
Oğuzhan
O
Okutan
Zafer
Z
Kartaloğlu
D000328:Adult; D015766:Albendazole / Q000627:therapeutic use; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D001196:Ascariasis / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology; D017164:Ascaris lumbricoides / Q000302:isolation & purification*; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000188:drug therapy / Q000469:parasitology; D003937:Diagnosis, Differential; D005243:Feces / Q000469:parasitology; D006801:Humans; D008297:Male; D010270:Parasite Egg Count; D018410:Pneumonia, Bacterial / Q000175:diagnosis; D011657:Pulmonary Eosinophilia / Q000175:diagnosis / Q000188:drug therapy / Q000469:parasitology*; D013183:Sputum / Q000382:microbiology
D000871:Anthelmintics; D015766:Albendazole