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Pulmonary anisakiasis presenting as eosinophilic pleural effusion
Wakana Saito1, Kenji Kawakami, Reiki Kuroki
1Department of Respiratory Medicine, Nagasaki Medical Center of Neurology (formerly Kawatana National Hospital), Kawatana, Japan.
Respirology (Carlton, Vic.)
|April 13, 2005
Summary
A man with eosinophilic pleural effusion was diagnosed with Anisakis simplex infection using serological tests. This parasitic infection can cause pulmonary symptoms, highlighting the importance of diagnostic screening.
Area of Science:
- Parasitology
- Pulmonology
- Immunology
Background:
- Pleural effusion with eosinophilia can have various causes.
- Anisakis simplex is a nematode parasite known to infect marine mammals and occasionally humans.
Observation:
- A 63-year-old male presented with significant eosinophilia in pleural fluid, exceeding peripheral blood levels.
- The patient's pleural effusion resolved spontaneously within a week.
Findings:
- Enzyme-linked immunosorbent assay (ELISA) for anisakiasis was positive in both serum and pleural fluid.
- Serum IgG antibody titers against Anisakis simplex showed a gradual decline over seven months.
- Larval migration from the alimentary canal through the diaphragm to the pleural cavity is the suspected mechanism.
Implications:
- Serological testing is a valuable diagnostic tool for identifying human pulmonary anisakiasis.
- This case underscores the potential for parasitic infections to manifest in the pleural space.
- Early diagnosis and identification of Anisakis simplex are crucial for appropriate management.