Home
Keys to Success in Medicine
Cardiovascular System
Respiratory System
Locomotor System
Endocrine and Metabolic System
Kidneys and Urinary System
Gastrointestinal Tract
Central Nervous System
Haematological System
Integumental System
Reproductive and Genital System
Recommended Reading
Forum
Links

amazon astore

ydr

aces for paces

Tropical Pulmonary Eosinophilia

Title               

Ñ    Tropical Pulmonary Eosinophilia

Definition

Ñ    Syndrome of immune hyper-responsiveness to microfilariae in the lungs

Aetiology

Ñ    Wucheriria bancrofti

Ñ    Brugia malayi

Pathogenesis

Ñ    Microfilariae opsonised with antibody, then cleared in pulmonary vasculature

Initially:

Ñ    Eosinophilic alveolitis:

Micorabscesses and granuloma may occur

Later:

Ñ    Cell infiltrate, early fibrosis

Finally:

Ñ    Cell infiltrate decreases, fibrosis increases scarring occurs

Clinical Features

History

Sex

Ñ    Males > Females

E&M

Ñ    Fever

Ñ    Malaise

Ñ    Weight loss

RS

Ñ    Cough:

Increased at night

Ñ    Breathlessness

Ñ    Wheeze

GIT

Ñ    Vomiting

Ñ    Diarrhoea

Social History

Ñ    Residence in or visit to an area where filariasis is endemic

Examination

E&M

Ñ    Fever

IS

Ñ    Clubbing:

Uncommon

RS

Ñ    Crepitations

Ñ    Rhonchi

HS

Ñ    Hepatomegaly

Ñ    Splenomegaly

Ñ    Lymphadenopathy

Complications

RS

Ñ    Pulmonary fibrosis

Investigations

Fluids

Blood

Haematology

Ñ    Eosinophilia:

3,000 – 50,000 /mm³

Immunology

Ñ    Ig E levels:

Elevated

Ñ    Filarial antibodies:

Positive

Imaging

Chest X-ray

Ñ    Military mottling

Ñ    Reticulonodular shadowing

Ñ    Prominent hilar shadows with increased vascular marking at the lung bases

Pulmonary Function Tests

Ñ    Vital capacity:

Decreased

Ñ    Total lung capacity:

Reduced

Ñ    Residual volume:

Decreased

Management

Cure

Drugs

Ñ    Diethylcarbamazine

Prevention

Drugs

Ñ    Mass treatment of populations at risk of filariasis

Biological Agents

Ñ    Vector control

Prognosis

Ñ    Untreated:

Pulmonary fibrosis may occur

Ñ    With treatment complete cure possible

[ Back ] [ Up ] [ Next ]

[Up]