Tropical Pulmonary Eosinophilia Masquerading as Interstitial Lung Disease: An Interesting Case Report with Review of Literature

Abstract

Tropical Pulmonary Eosinophilia (TPE) is a form of occult filariasis characterised clinically by paroxysms of nocturnal cough, wheezing and dyspnoea . It is due to hyper-responsive pulmonary reaction to trapped microfilaria inside the lung tissue. Though, it is common in endemic areas, it is frequently misdiagnosed mostly as bronchial asthma or tuberculosis and the patient continues to suffer without being treated appropriately. A 36-year-old male, who presented with fever, cough and shortness of breath for a period of six months was misdiagnosed as Interstitial Lung Disease (ILD) and was put on antifibrotic agents without any relief of symptoms. He was thoroughly investigated with routine haematological tests, Absolute Eosinophil Count (AEC), X-ray of chest, High Resolution Computed Tomography (HRCT) thorax including bronchoalveolar lavage and was diagnosed as Tropical Pulmonary Eosinophilia (TPE). Diethyl Carbamazine citrate (DEC) was initiated and patient had satisfactory recovery. So, in endemic areas the possibility of TPE should always be kept in mind while evaluating cases presenting with chronic cough, dyspnoea and wheezing, even if the radiological imaging may mimic ILD.

Keywords

• eosinophilic pneumonia
• lymphatic filariasis
• pulmonary infiltrates with eosinophilia