RESUMEN
Nonepisodic angioedema with eosinophilia (NEAE) is characterised by a single episode of angioedema localised to the extremities and peripheral eosinophilia. While NEAE can develop in response to infection or vaccination, NEAE associated with acute parvovirus B19 (B19V) infection is rare. We describe the case of a young woman with NEAE that developed during acute B19V infection. She presented with 1-week history of pruritus and polyarthralgia in the extremities, followed by the development of peripheral oedema, and was positive for anti-B19V IgM antibody. Her arthralgia improved within 2 weeks without any specific intervention; however, the oedema and pruritic erythema persisted and the peripheral eosinophil count increased. A short course of prednisolone therapy for suspected NEAE alleviated the symptoms, which have not recurred for more than 2 years. Thus, we believe that the patient was affected by NEAE and that NEAE can develop following acute B19 infection.
Asunto(s)
Angioedema , Eosinofilia , Parvovirus B19 Humano , Humanos , Femenino , Parvovirus B19 Humano/inmunología , Angioedema/tratamiento farmacológico , Angioedema/virología , Angioedema/diagnóstico , Eosinofilia/tratamiento farmacológico , Eosinofilia/virología , Eosinofilia/complicaciones , Prednisolona/uso terapéutico , Adulto , Eritema Infeccioso/complicaciones , Eritema Infeccioso/diagnóstico , Infecciones por Parvoviridae/complicaciones , Infecciones por Parvoviridae/diagnóstico , Infecciones por Parvoviridae/tratamiento farmacológico , Artralgia/etiología , Artralgia/virología , Enfermedad AgudaRESUMEN
Eosinophilic gastroenteritis (EG) is an inflammatory bowel condition characterised by eosinophilic infiltration of the stomach and small bowel. Smoking and certain foods can trigger EG.A man in his 40s presented to the emergency department with acute abdominal pain. He had rebound tenderness and guarding on his initial abdominal examination. A subsequent CT scan showed jejunal wall thickening and ascitesHe had similar attacks of abdominal pain and was misdiagnosed with familial Mediterranean fever and Crohn's disease.Paracentesis revealed eosinophilic ascites. No mucosal abnormality was detected on gastroduodenoscopy and colonoscopy. A double-balloon enteroscopy revealed mucosal inflammation in the jejunum and a biopsy was taken. In this biopsy, eosinophilic jejunitis was detected. He was given corticosteroids and montelukast and his condition was resolved promptly. After discharge, he had attacks of EG until he quit smoking. After quitting smoking, he had an attack once in the last 2 years after consuming eggplant.
Asunto(s)
Abdomen Agudo , Ascitis , Enteritis , Eosinofilia , Gastritis , Humanos , Masculino , Eosinofilia/diagnóstico , Eosinofilia/complicaciones , Abdomen Agudo/etiología , Enteritis/diagnóstico , Enteritis/complicaciones , Enteritis/tratamiento farmacológico , Gastritis/diagnóstico , Gastritis/complicaciones , Adulto , Ascitis/etiología , Diagnóstico Diferencial , Tomografía Computarizada por Rayos XRESUMEN
Chronic sinusitis with nasal polyps (CRSwNP) is a complex inflammatory condition characterized by recurring nasal polyps, often necessitating repeated interventions. Blood eosinophilia has emerged as a potential biomarker for predicting disease recurrence. The present study aims to assess the predictive significance of blood eosinophilia for the recurrence of nasal polyps. To accomplish this objective, we employed the appropriate search keywords to explore international databases such as Web of Science, PubMed, Embase, and Scopus. Through this process, we extracted scholarly articles that assessed the prognostic value of blood eosinophilia in the recurrence of nasal polyps. The statistical software STATA (version 15) was employed, along with random and fixed-effects models, to appraise the compiled data. Nine articles met inclusion criteria, with a total sample size of 1279 individuals (569 recurrent polyp individuals and 710 non-recurrent polyp individuals). Cumulative Odds ratio analysis revealed that CRSwNP is associated with high blood eosinophile percentage compared to the non-CRSwNP group (p=0.01, OR=1.26, 95%Cl (1.15,1.36). The cut-off value of blood eosinophil percentage (>0.78) had relatively good, and statistically significant predictive potential. No significant publication bias was observed for the included studies. Our findings indicate that the utilization of blood eosinophils holds significant predictive value and can serve as a valuable tool for detecting recurrence in patients with CRSwNP. Based on the outcomes of our comprehensive analysis, we propose a threshold of >0.78 as a reliable indicator for assessing the probability of recurrence in CRSwNP patients.
Asunto(s)
Eosinofilia , Pólipos Nasales , Recurrencia , Sinusitis , Humanos , Pólipos Nasales/sangre , Pólipos Nasales/complicaciones , Pólipos Nasales/patología , Pólipos Nasales/diagnóstico , Sinusitis/sangre , Sinusitis/complicaciones , Sinusitis/patología , Eosinofilia/sangre , Eosinofilia/complicaciones , Eosinofilia/patología , Enfermedad Crónica , Eosinófilos/patología , Pronóstico , Oportunidad RelativaRESUMEN
BACKGROUD: Presently, the impact of Chronic rhinosinusitis with nasal polyps (CRSwNP) on asthma onset is unknown. AIMS: To evaluate the role of CRSwNP in asthma onset. MATERIALS AND METHODS: A total of 3107 CRSwNP patients were retrospectively screened from 1 January 2018, to 31 May 2021; 624 patients were enrolled. Clinical data regarding nasal symptoms, Lund-Mackay scores, blood eosinophil percentage, and onset of asthma were analyzed. Patients were divided into different groups according to past history of nasal polyps, Lund-Mackay score, and the extent of blood eosinophilia. Asthma-free rates between these subgroups were analyzed by Kaplan-Meier curves and Cox regression models. RESULTS: The prevalence of asthma was 10.90% in patients with CRSwNP, and new-onset asthma occurred in 3.14% of these patients. Higher Lund-Mackay scores for ethmoid sinus and maxillary sinus (E/M) and blood eosinophil percentages were two independent risk factors for new-onset asthma, with hazard ratios of 1.267 (95%CI, 1.155-1.390) and 1.224 (95%CI, 1.054-1.422), respectively. CRSwNP patients with an E/M ratio > 2.33 or a blood Eos percentage > 5.5% were at risk for asthma onset. CONCLUSIONS AND SIGNIFICANCE: Blood eosinophilia and a higher E/M score ratio were associated with new-onset asthma in patients with CRSwNP.
Asunto(s)
Asma , Eosinofilia , Senos Etmoidales , Pólipos Nasales , Rinitis , Sinusitis , Humanos , Sinusitis/complicaciones , Sinusitis/sangre , Asma/complicaciones , Asma/epidemiología , Masculino , Femenino , Pólipos Nasales/complicaciones , Pólipos Nasales/sangre , Pólipos Nasales/epidemiología , Rinitis/complicaciones , Rinitis/sangre , Eosinofilia/complicaciones , Eosinofilia/sangre , Eosinofilia/epidemiología , Persona de Mediana Edad , Enfermedad Crónica , Estudios Retrospectivos , Adulto , Seno Maxilar , Factores de Riesgo , Prevalencia , Anciano , RinosinusitisRESUMEN
BACKGROUND: Eosinophilic solid and cystic renal cell carcinoma (ESC-RCC) is a novel subtype of renal cell carcinoma characterized by its relatively low incidence and indolent behavior. We report a rare case of ESC-RCC concurrent with clear cell renal cell carcinoma (ccRCC) in a single kidney. CASE PRESENTATION: A 48-year-old male, was found to have a mixed echogenic mass in the left kidney during a physical examination. He has no history of hematuria and flank pain. An abdominal CT scan revealed a 3.0 * 1.9 * 2.5 cm3 mass with unclearly bordered at the lower pole of the left kidney. Abdominal MRI showed two nodules of different sizes in the left kidney, suggesting the possibility of a tumor. The patient underwent a subtotal nephrectomy, and the postoperative pathological results indicated ESC-RCC combined with ccRCC. The patient recovered well without tumor recurrence during the 12-month follow-up. CONCLUSION: We reported a case of renal composite tumors, comprising the rare ESC-RCC and the more common ccRCC. Imaging combined with postoperative pathological examination is crucial for the definitive diagnosis of these rare tumors.
Asunto(s)
Carcinoma de Células Renales , Neoplasias Renales , Humanos , Carcinoma de Células Renales/cirugía , Carcinoma de Células Renales/diagnóstico por imagen , Masculino , Neoplasias Renales/cirugía , Neoplasias Renales/diagnóstico por imagen , Neoplasias Renales/patología , Persona de Mediana Edad , Neoplasias Primarias Múltiples/cirugía , Neoplasias Primarias Múltiples/diagnóstico por imagen , Neoplasias Primarias Múltiples/patología , Eosinofilia/complicacionesRESUMEN
BACKGROUND: Atypical chronic myeloid leukemia (aCML) is a highly aggressive type of blood cancer that falls under the category of myelodysplastic/myeloproliferative neoplasms (MDS/MPN). In the fifth edition of the WHO classification of tumors, this category has been renamed MDS/MPN with neutrophilia. Although eosinophilia is commonly observed in blood cancers, it is rarely seen in aCML. CASE PRESENTATION: This study presents a case of aCML that was diagnosed six years after the patient developed eosinophilia. The patient had undergone tests to rule out other primary and secondary diseases, but the eosinophilia remained unexplained. Treatment with corticosteroids and hydroxyurea had proven ineffective. Six years later, the patient experienced an increase in white blood cells, primarily neutrophils. After ruling out other possible diagnoses, a combination of morphologic and molecular genetic findings led to the diagnosis of aCML. The patient responded well to treatment with azacitidine. CONCLUSIONS: This study summarizes the current state of aCML diagnosis and management and discusses the possible connection between eosinophilia and aCML.
Asunto(s)
Eosinofilia , Humanos , Eosinofilia/diagnóstico , Eosinofilia/complicaciones , Masculino , Leucemia Mieloide Crónica Atípica BCR-ABL Negativa/diagnóstico , Leucemia Mieloide Crónica Atípica BCR-ABL Negativa/tratamiento farmacológico , Factores de Tiempo , AncianoRESUMEN
This case report describes a diagnosis of idiopathic eosinophilic endomyocarditis in a male patient who presented with progressive dyspnea, eosinophilia, thrombocytopenia, and elevated troponin T level.
Asunto(s)
Disnea , Eosinofilia , Humanos , Masculino , Disnea/etiología , Eosinofilia/diagnóstico , Eosinofilia/complicaciones , Persona de Mediana Edad , Diagnóstico Diferencial , EcocardiografíaRESUMEN
In solid tumors, hypereosinophilia is a rare phenomenon and is mainly associated with mucin-secreting carcinomas. Thyroid tumors associated with neutrophilia and/or eosinophilia have been described exclusively in patients with anaplastic thyroid cancer. Eosinophilia associated with papillary thyroid cancer is extremely rare and there are very few cases currently described. It has been suggested that three cytokines, namely interleukin-3 (IL-3), interleukin-5 (IL-5), and granulocyte-macrophage colony-stimulating factor (GM-CSF), may act as a peptide potential eosinophilic. To date, only three patients with differentiated thyroid cancer associated with eosinophilia have been reported, two of the papillary type and one of the medullary type. A 48-year-old patient consulted in 2022 due to bilateral cervical lymphadenopathy of 3 years' duration associated with wasting syndrome and hypereosinophilia. PET CT was requested, which showed hypermetabolic focus in the right thyroid lobe and lymph node, lung, bone, and liver metastases; Thyroid ultrasound showing a nodule of high suspicion of malignancy and a conglomerate of lymphadenopathy in the right lobe with positive needle wash for thyroglobulin. Hypereosinophilia was evaluated with initial leukocytosis values of GB 30,310/mm3 (10,608/mm3 of eosinophils) to maximum values of GB 77,090/mm3 (eosinophils 20,814/mm3). It was interpreted as paraneoplastic syndrome and corticosteroid therapy was started at immunosuppressive doses without response. Our observations presented in this article are in line with most studies reflecting that paraneoplastic hypereosinophilia is characterized by more advanced disease and poor prognosis.
En los tumores sólidos la hipereosinofilia es un fenómeno raro y se asocia principalmente con carcinomas secretores de mucina. Los tumores tiroideos asociados a neutrofilia y/o eosinofilia se han descrito exclusivamente en pacientes con cáncer anaplásico de tiroides. La eosinofilia asociada con cáncer papilar de tiroides es extremadamente rara y se encuentran muy pocos casos descriptos actualmente. Se ha sugerido que tres citocinas, a saber, la interleucina-3 (IL-3), la interleucina-5 (IL-5) y el factor estimulante de colonias de granulocitos y macrófagos (GM-CSF), pueden actuar como un péptido eosinofílico potencial. Hasta el momento solo se han reportado tres pacientes con cáncer diferenciado de tiroides asociados a eosinofilia, dos de tipo papilar y uno de tipo medular. Paciente de 48 años consultó en el año 2022 por adenopatías cervicales bilaterales de 3 años de evolución asociado a síndrome consuntivo e hipereosinofilia. Se solicitó PET CT que evidenció foco hipermetabólico en lóbulo tiroideo derecho y metástasis ganglionares, pulmonares, óseas y hepáticas; ecografía tiroidea que evidencia en lóbulo derecho nódulo de alta sospecha de malignidad y conglomerado de adenopatías con lavado de aguja positivo para tiroglobulina. Evaluada la hipereosinofilia con valores iniciales de leucocitosis de GB 30310/mm3 (10608/mm3 de eosinófilos) hasta valores máximos de GB 77090/mm3 (eosinófilos 20814/mm3) se interpretó como síndrome paraneoplásico y se inició corticoterapia en dosis inmunosupresoras sin respuesta. Nuestras observaciones presentadas en este artículo están en línea con la mayoría de los estudios que reflejan que la hipereosinofilia paraneoplásica se caracteriza por una enfermedad más avanzada y un mal pronóstico.
Asunto(s)
Síndromes Paraneoplásicos , Neoplasias de la Tiroides , Humanos , Persona de Mediana Edad , Neoplasias de la Tiroides/complicaciones , Neoplasias de la Tiroides/patología , Síndromes Paraneoplásicos/etiología , Síndrome Hipereosinofílico/complicaciones , Masculino , Femenino , Carcinoma Papilar/complicaciones , Eosinofilia/complicacionesAsunto(s)
Linfoma no Hodgkin , Humanos , Linfoma no Hodgkin/diagnóstico , Linfoma no Hodgkin/complicaciones , Masculino , Eosinofilia/diagnóstico , Eosinofilia/complicaciones , Ecocardiografía , Persona de Mediana Edad , Fibrosis Endomiocárdica/diagnóstico , Fibrosis Endomiocárdica/complicaciones , Biopsia , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/complicaciones , FemeninoRESUMEN
The large spectrum of etiologies, severities, and histologic appearances of eosinophilic myocarditis (EoM) poses challenges to its diagnosis and management. Endomyocardial biopsy is the current gold standard for diagnosis. However, cardiovascular magnetic resonance imaging is becoming more frequently used to diagnose acute myocarditis because of enhanced sensitivity when compared to histopathologic examination, and its less invasive nature. We report a complicated case of EoM in a male in his mid-thirties that led to fulminant cardiogenic shock that required immunosuppressive therapy on day 5 of admission and implantation of a left ventricular assist device (LVAD) on day 30. EoM was diagnosed on histopathologic examination of the resected fragment of the left ventricular myocardium. Nine months after the initial presentation, the patient ultimately required heart transplantation. The explanted heart showed minimal residual interstitial inflammation with evidence of mildly active intimal arteritis and patchy areas of interstitial fibrosis. In this report, we describe our patient's clinical features and correlate them with imaging and histopathologic findings to illustrate the difficulty in diagnosing EoM, particularly in this complicated patient that ultimately required heart transplantation. The diagnosis can be challenging due to the variable histopathologic features, clinical presentation, and utilization of therapeutic medications and devices.
Asunto(s)
Eosinofilia , Insuficiencia Cardíaca , Trasplante de Corazón , Corazón Auxiliar , Miocarditis , Miocardio , Humanos , Masculino , Miocarditis/patología , Insuficiencia Cardíaca/etiología , Eosinofilia/patología , Eosinofilia/complicaciones , Adulto , Miocardio/patología , Biopsia , Inmunosupresores/uso terapéutico , Resultado del Tratamiento , Choque Cardiogénico/etiología , Choque Cardiogénico/patología , Choque Cardiogénico/terapia , Choque Cardiogénico/diagnósticoRESUMEN
A 47-year-old Japanese woman presented with a 1-year history of right-sided epiphora. On initial consultation, the patient had a high right tear meniscus height. CT images revealed bilateral soft tissue opacification in the nasal cavity and maxillary, frontal, and ethmoid sinuses. The lesion in the right nasal cavity and maxillary sinus involved the right lacrimal sac and nasolacrimal duct. Blood test results showed elevated eosinophil count. Endoscopic sinus surgery and excisional biopsy of the nasolacrimal duct were performed. Histopathological examinations of the excised right nasolacrimal duct and nasal polyps from the nasal cavity and maxillary sinus showed high levels of eosinophilic inflammatory infiltrates. The definite diagnosis of eosinophilic chronic rhinosinusitis was made, based on clinical, radiological, and histopathological findings. At 1.5-year follow-up, tear meniscus height was normal, the lacrimal drainage system remained patent, and the rhinosinusitis did not recur.
Asunto(s)
Eosinofilia , Obstrucción del Conducto Lagrimal , Conducto Nasolagrimal , Rinitis , Sinusitis , Tomografía Computarizada por Rayos X , Humanos , Femenino , Persona de Mediana Edad , Sinusitis/diagnóstico , Sinusitis/complicaciones , Enfermedad Crónica , Rinitis/diagnóstico , Rinitis/complicaciones , Conducto Nasolagrimal/patología , Conducto Nasolagrimal/diagnóstico por imagen , Obstrucción del Conducto Lagrimal/diagnóstico , Obstrucción del Conducto Lagrimal/etiología , Eosinofilia/diagnóstico , Eosinofilia/complicaciones , Endoscopía , RinosinusitisRESUMEN
Eosinophilic otitis media (EoOM) is a variant of exudative otitis media characterized by a persistent persistent course, the presence of a very viscous effusion in the tympanic cavity, comorbidally associated with chronic polypous rhinosinusitis and bronchial asthma. The disease is characterized by a persistent progressive course, which can lead to a gradual decrease in hearing up to complete deafness. Conservative treatment methods for EoOM include local and systemic administration of glucocorticosteroids. Encouraging data on the effectiveness of biological therapy have appeared in recent publications. The above clinical observation examines the course of EoOM in a patient who received biological therapy with dupilamab.
Asunto(s)
Otitis Media con Derrame , Rinitis , Sinusitis , Humanos , Sinusitis/complicaciones , Sinusitis/terapia , Sinusitis/diagnóstico , Rinitis/terapia , Rinitis/complicaciones , Rinitis/tratamiento farmacológico , Enfermedad Crónica , Resultado del Tratamiento , Otitis Media con Derrame/etiología , Otitis Media con Derrame/diagnóstico , Otitis Media con Derrame/terapia , Eosinofilia/complicaciones , Masculino , Femenino , Terapia Biológica/métodos , RinosinusitisAsunto(s)
Eosinofilia , Pólipos Nasales , Rinitis , Sinusitis , Humanos , Pólipos Nasales/complicaciones , Sinusitis/complicaciones , Eosinofilia/sangre , Eosinofilia/complicaciones , Enfermedad Crónica , Femenino , Masculino , Rinitis/complicaciones , Adulto , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , RinosinusitisRESUMEN
Eosinophilic myocarditis can result in endomyocardial fibrosis affecting both ventricles, leading to restrictive cardiomyopathy. Multimodality imaging is crucial for diagnosis, as demonstrated in this case of a patient presenting with symptoms of heart failure.
Asunto(s)
Síndrome Hipereosinofílico , Imagen Multimodal , Miocarditis , Valor Predictivo de las Pruebas , Humanos , Síndrome Hipereosinofílico/complicaciones , Síndrome Hipereosinofílico/diagnóstico por imagen , Síndrome Hipereosinofílico/tratamiento farmacológico , Miocarditis/diagnóstico por imagen , Miocarditis/complicaciones , Masculino , Insuficiencia Cardíaca/etiología , Insuficiencia Cardíaca/diagnóstico por imagen , Fibrosis Endomiocárdica/diagnóstico por imagen , Fibrosis Endomiocárdica/complicaciones , Eosinofilia/diagnóstico por imagen , Eosinofilia/complicaciones , Miocardio/patología , Biopsia , Imagen por Resonancia Cinemagnética , Persona de Mediana Edad , Imagen por Resonancia MagnéticaRESUMEN
A man in his 60s presented with a widespread erythematous rash and associated chills, paraesthesia and haematuria. He had recently commenced naproxen/esomeprazole. Blood tests showed hypereosinophilia (0.73×109/L) and moderate acute kidney injury. Histology revealed parakeratosis, mild spongiosis with eosinophils. He developed acute coronary syndrome with rapid atrial fibrillation. Coronary angiogram was non-obstructive. Cardiac MRI (CMR) revealed acute myocarditis secondary to Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS). Naproxen/esomeprazole was discontinued, and he was supported with oral corticosteroids. A repeat CMR 3 months later showed resolution of myocarditis. Naproxen/esomeprazole is not a common offending drug. DRESS is a rare drug-induced hypersensitivity reaction with a mortality rate of 10%. The objective of this case report is to highlight the significant but rare cardiac complications that can ensue from DRESS, which warrant prompt recognition and withdrawal of the causative drug.
Asunto(s)
Síndrome de Hipersensibilidad a Medicamentos , Eosinofilia , Miocarditis , Humanos , Masculino , Síndrome de Hipersensibilidad a Medicamentos/diagnóstico , Eosinofilia/complicaciones , Esomeprazol/efectos adversos , Miocarditis/complicaciones , Naproxeno/efectos adversos , Persona de Mediana EdadRESUMEN
Migrant patients share the same diseases as natives, but biological or environmental differences may lead to distinct prevalence and manifestations of certain syndromes. Some common conditions in Primary Care stand out, such as fever, diarrhea, anemia, eosinophilia, and chronic cough, where it is important to have a special consideration. Fever may indicate a serious imported illness, and malaria should always be ruled out. Diarrhea is generally of infectious origin, and in most cases, management is outpatient. Anemia may indicate malnutrition or malabsorption, while eosinophilia may indicate a parasitic infection. Lastly, chronic cough may be a sign of tuberculosis, especially in immigrants from endemic areas. Family medicine holds a privileged position for the comprehensive, culturally sensitive, and person-centered approach to these conditions.
Asunto(s)
Anemia , Tos , Diarrea , Eosinofilia , Fiebre , Humanos , Eosinofilia/complicaciones , Eosinofilia/diagnóstico , Anemia/etiología , Anemia/diagnóstico , Enfermedad Crónica , Diarrea/etiología , Tos/etiología , Fiebre/etiología , Síndrome , Migrantes , Tos CrónicaRESUMEN
BACKGROUND Scleroderma is a chronic autoimmune disease characterized by angiopathy, autoimmunity, and fibrosis. One form of scleroderma, systemic sclerosis, is characterized by diffuse skin lesions and visceral involvement. Eosinophilic pleural effusion is a rare complication attributed to a large array of diseases. We present a case of a man with underlying systemic sclerosis who developed eosinophilic pleural effusion as a complication of associated Trichinella spiralis infection. CASE REPORT A 49-year-old man presented for bilateral inflammatory radio-ulnar-carpal joint pain, paresthesia of the hands and forearms and a 2-week history of right posterior aching thoracic pain and night sweats. The physical examination revealed sclerodermatous skin involvement of the hands, forearms, and forehead, sclerodactyly, Raynaud's phenomenon, and telangiectasias, together with muffled cardiac sounds and right basal abolishment of the vesicular breath sounds. Imagistic evaluation showed the presence of pleuro-pericardial fluid. A thoracocentesis highlighted the presence of an exudative eosinophilic pleural effusion. Laboratory findings showed leukocytosis, with elevated neutrophil and eosinophil counts. The patient was tested for a parasitic infection, but initially the results were negative. He started anti-inflammatory treatment, but no reduction of the pleural fluid was observed. Subsequent evaluation revealed specific anti-trichinella IgG antibodies. Albendazole and corticosteroid therapy were initiated, which resulted in remission of the symptoms. CONCLUSIONS This report highlights the possibility of developing rare or even not-until-now seen complications when 2 etiologically different diseases are associated. The physician should carefully assess the situation to find and resolve the underlying causes.
Asunto(s)
Eosinofilia , Derrame Pleural , Esclerodermia Sistémica , Trichinella spiralis , Triquinelosis , Humanos , Masculino , Persona de Mediana Edad , Esclerodermia Sistémica/complicaciones , Esclerodermia Sistémica/diagnóstico , Triquinelosis/complicaciones , Triquinelosis/diagnóstico , Derrame Pleural/etiología , Derrame Pleural/parasitología , Eosinofilia/parasitología , Eosinofilia/complicaciones , AnimalesRESUMEN
We report the case of a patient who has been hospitalized for dyspnea. Investigations revealed airway obstruction, eosinophilia, elevated IgE and elevated exhaled nitric oxide. Patient improved with oral corticosteroids (OCS). However, the patient presented two exacerbations requiring OCS during the next twelve months. Chest CT scan revealed two multiloculated parenchymal lesions. Lab test was positive for Echinococcus and Western-Blot confirmed infection with Echinococcus granulosus. Bronchoalveolar lavage confirmed the presence of 6 % eosinophils. Echinococcus granulosis is a zoonotic larval infection caused by a tapeworm larva. Patients with this disease may be asymptomatic for years. Early identification and management, in a multidisciplinary team, are essential and rely mainly on surgical intervention and antiparasitic treatments. This article presents the case of a young patient with pulmonary echinococcosis.
Nous rapportons le cas d'un patient ayant été hospitalisé dans un contexte d'obstruction bronchique, avec une légère éosinophilie, une élévation des IgE et du monoxyde d'azote dans l'air exhalé, qui a évolué favorablement sous corticostéroïdes oraux (CSO). L'évolution est marquée par deux exacerbations d'asthme d'évolution favorable sous CSO dans les douze mois de suivi. Une tomodensitométrie thoracique révèle la présence de deux lésions pulmonaires kystiques. Les sérologies infectieuses mettent en évidence une positivité pour l'espèce -Echinococcus et une confirmation pour l'Echinococcus granulosus. Le lavage broncho-alvéolaire retrouve une hyperéosinophilie à 6 %. L'échinococcose kystique est une infection larvaire zoonotique causée par une larve de taenia. Les patients atteints de cette maladie peuvent être asymptomatiques pendant de nombreuses années. Une identification précoce et une prise en charge adéquate, en équipe pluridisciplinaire, sont primordiales et reposent essentiellement sur une intervention chirurgicale et des traitements anti-parasitaires. Cet article présente le cas d'un jeune patient atteint d'une échinococcose kystique pulmonaire.