Clinical Infection in Practice (Nov 2021)
Image challenge: Beware of diagnostic anchoring – An offshore vessel welding inspector with eosinophilia and a cough productive of ‘worms’
Abstract
A 38-year old male was referred from an Acute Medical Unit to a regional Tropical Infectious Disease Unit with a seven-week history of dyspnoea, wheeze and cough reportedly productive of worms. The patient had taken photographs of the expectorated substance which allowed macroscopic examination by a consultant in infectious diseases. Fresh samples were also sent for histological examination. Initial investigations showed a prominent eosinophilia of 2.5 × 109/ml (0.0-0.4 × 109/ml).
