Indian Journal of Radiology and Imaging Indian Journal of Radiology and Imaging

LETTER TO EDITOR
Year
: 1999  |  Volume : 9  |  Issue : 2  |  Page : 86--87

Tropical pulmonary eosinophilia presenting as consolidation


Surya Kant, S Bhadury, VK Ojha, PK Mukherji 
 Department of Tuberculosis and Chest Diseases and Radiodiagnosis, King George's Medical College, Lucknow, India

Correspondence Address:
Surya Kant
Department of Tuberculosis and Chest Diseases and Radiodiagnosis, King George«SQ»s Medical College, Lucknow
India




How to cite this article:
Kant S, Bhadury S, Ojha V K, Mukherji P K. Tropical pulmonary eosinophilia presenting as consolidation.Indian J Radiol Imaging 1999;9:86-87


How to cite this URL:
Kant S, Bhadury S, Ojha V K, Mukherji P K. Tropical pulmonary eosinophilia presenting as consolidation. Indian J Radiol Imaging [serial online] 1999 [cited 2019 Sep 20 ];9:86-87
Available from: http://www.ijri.org/text.asp?1999/9/2/86/28343


Full Text

Sir,

We wish to report a case of a tropical pulmonary eosinophilia as a rare presentation of consolidation. The patient responded well to diethyl-carbamazine therapy. A nine-year old child presented with symptoms of cough with minimal expectoration, mild breathlessness and left-sided dull aching chest pain of two weeks duration. There was no history of fever, weight loss, hemoptysis and passage of worms in the stool. He had taken antibiotics, bronchodilators and analgesics in the past without any relief. Physical examination of the chest revealed a few course crepitations in the left infrascapular area. Investigations revealed a hemoglobin level of 11gm%, total blood leukocyte count of 11000/cu mm and an absolute eosinophil count of 2420/cu mm. The sputum was persistently negative for acid fast bacilli and showed no growth of any microorganism on culture. Mantoux test was negative. Stool examination did not show any ova or cyst. Urine, blood urea and blood sugar were normal. The chest radiograph revealed consolidation in the left mid and lower zones [Figure 1]. The patient was treated with diethyl-carbamazine for three weeks. He had marked relief from symptoms and became asymptomatic in two weeks. A repeat chest radiograph view revealed resolution of the consolidation [Figure 2]. His absolute eosinophil count became normal after three weeks of diethyl-carbamazine therapy. On subsequent follow-up, the child revealed no abnormality.

The usual radiological features of tropical pulmonary eosinophilia are miliary mottling, the nodules being 1-3 mm in diameter, prominent hila with increased vascular markings or reticulo-nodular shadows predominantly seen in the mid and lower zones [1]. Sometimes, it may also present as cavitation, pleural effusion, pneumothorax, hydro-pneumothorax and cardiomegaly [2],[3]. Consolidation is a rare radiological presentation of tropical pulmonary eosinophilia [1]. Only a few cases have been reported in literature [4]. The exact mechanism of consolidation in cases of tropical pulmonary eosinophilia is not known. It may possibly develop as a result of a hypersensitivity phenomenon induced by microfilarial infestation.

References

1Khoo FY, Danaraj TJ. The roentogenographic appearance of eosinophilic lung (Tropical Eosinophilia). Am J Roentogenology 1960; 83: 251- 260.
2Vijayan VK. Tropical pulmonary eosinophilia. Indian J Chest Dis Allied Sci 1996; 38: 169-180.
3Prasad R, Tandon S, Kant S, Mukerji PK. Hydro-pneumothorax in tropical pulmonary eosinophilia. Ind J Tub 1996; 43: 205-206.
4Raj B, Gupta KB, Chawla RK, Janmeja AK. Tropical pulmonary eosinophilia presenting pneumonic consolidation. Indian J chest Dis All Sci 1987; 29: 175-177.