ABSTRACT
Sparganosis has a world wide distribution, but only a few patients have pulmonary involvement. The term sparganosis is defined as an infection by the larva of parasitic tapeworms of Spirometra species. We present here-in a patient, who was infected by this parasite and had pulmonary symptoms. The chest roentgenography revealed diffuse multiple nodular infiltration with cavitations. Bronchoscopy with a transbronchial lung biopsy was nondiagnostic. Finally, open lung biopsy was performed, and the histologic examination revealed plerocercoid larva of sparganum. The patient was treated with mebendazole 40 mg/kg/day for 6 months and his symptoms and pulmonary function improved. In the 5th year of follow-up, he presented with more progressive dyspnea and developed cor pulmonale, and finally died from pneumonia with sepsis. The objective of this report was to present a rare manifestation of sparganosis and it's clinical course. Currently, there is no known effective treatment for this disease.
Subject(s)
Adult , Anti-Bacterial Agents , Bacteremia/diagnosis , Biopsy, Needle , Disease Progression , Fatal Outcome , Follow-Up Studies , Humans , Klebsiella Infections/diagnosis , Lung Diseases, Parasitic/diagnosis , Male , Mebendazole/therapeutic use , Respiratory Function Tests , Sparganosis/diagnosis , ThailandABSTRACT
Chronic eosinophilic pneumonia (CEP) is a disorder, characterized by a history of pneumonia (> 2 months) and eosinophilic pulmonary infiltration without any organic causes. We describe a 28-year-old woman who presented with cough, dyspnea and fever for 2 months. She was diagnosed with mild asthma and allergic rhinitis 2 years before being diagnosed with CEP. For a period of 9 months she took no medication. Her chest roentgenogram at this admission revealed patchy infiltration in both upper lung fields. Laboratory data revealed blood eosinophilia (4,284/mm3), and her serum IgE was mildly elevated (245.8 IU/ml). A computerized tomography of the chest did not show bronchiectasis. CEP was diagnosed from significant eosinophilia in bronchoalveolar larvage fluid and transbronchial biopsy revealed eosinophilic infiltration without any demonstrable infectious agent. The patient was treated with prednisolone 45 mg/day. Her symptoms disappeared and her chest roentgenogram showed nearly complete resolution in 2 and 4 days, consecutively.
Subject(s)
Adult , Anti-Inflammatory Agents/therapeutic use , Biopsy , Bronchoalveolar Lavage Fluid , Chronic Disease , Cough/etiology , Dyspnea/etiology , Eosinophils , Female , Fever/etiology , Humans , Immunoglobulin E/blood , Leukocyte Count , Prednisolone/therapeutic use , Pulmonary Eosinophilia/blood , Thailand , Tomography, X-Ray ComputedABSTRACT
A prospective study of community-acquired pneumonia in adults at Srinagarind Hospital, Khon kaen University was conducted from September 1987 to August 1988. Laboratory specimens were tested for bacterial and mycoplasmal culture, CIE for pneumococcal antigen and serological data for mycoplasma and P. pseudomallei. The results supported by clinical data were evaluated. We could identify the pathogens from 62 of 113 cases (55%). P. pseudomallei was the most frequent etiologic agent (32%) and S. pneumoniae was the second (27%). Overall mortality was 21 per cent and it was high in cases with bacteremia and pneumonia due to P. pseudomallei. Sixty-six per cent of the patients had associated diseases. Diabetes mellitus, chronic renal failure and renal calculi were commonly found in patients with pneumonia due to P. pseudomallei. The results of this study showed the relatively high prevalence of P. pseudomallei pneumonia in our region which was different from other reports.