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Journal of Clinical Pathology 2007;60:202-203; doi:10.1136/jcp.2006.037267
Copyright © 2007 by the BMJ Publishing Group Ltd & Association of Clinical Pathologists.

CASE REPORT

Ascaris-induced eosinophilic pneumonitis in an HIV-infected patient

Susanna Kar Pui Lau1, Patrick C Y Woo1, Samson S Y Wong1, Edmond S K Ma2 and Kwok-yung Yuen1

1 Department of Microbiology, The University of Hong Kong, Hong Kong
2 Department of Pathology, The University of Hong Kong, Hong Kong

Correspondence to:
Correspondence to:
Dr K-y Yuen
Department of Microbiology, The University of Hong Kong, University Pathology Building, Queen Mary Hospital Compound, Pokfulam Road, Hong Kong; hkumicro{at}hkucc.hku.hk

ABSTRACT

A case of Ascaris-induced eosinophilic pneumonitis in an HIV-infected patient is described. Owing to his HIV status and the absence of peripheral blood eosinophilia on admission, the initial diagnosis was incorrect until the passage of two worms in his stool. The patient developed eosinophilia subsequently, and examination of his sputum also showed increased eosinophils. The patient gradually improved with inhaled bronchodilators, steroid and mebendazole. As peripheral blood eosinophilia may be transient and the larval migration phase occurs before eggs are present in stool, a high index of suspicion is required in making the diagnosis of Ascaris pneumonitis. Examination of sputum for larvae or increased eosinophils should be performed in patients suspected of having pulmonary infiltrates from endemic areas irrespective of peripheral blood eosinophil counts.


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