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[Loeffler's syndrome mimicking bronchial asthma and pneumonia in a child: case report]
Uğur Deveci1, Cemal Üstün, Hasan Baki Altınsoy
1Elazığ Eğitim ve Araştırma Hastanesi, Pediatri Kliniği, Elazığ, Türkiye.
Insights
A child with asthma-like symptoms was diagnosed with Loeffler's syndrome caused by Ascaris lumbricoides. Early radiological diagnosis prevented unnecessary treatments for this parasitic lung infection.
Area of Science:
- Pulmonology
- Infectious Diseases
- Radiology
Background:
- A 14-year-old male presented with symptoms mimicking bronchial asthma and pneumonia, including wheezing, cough, dyspnea, and sputum.
- Empirical treatment for asthma and pneumonia yielded no clinical or radiological improvement.
Purpose of the Study:
- To report a case of Loeffler's syndrome in a child.
- To highlight the diagnostic utility of radiological imaging in parasitic lung infections.
- To emphasize considering Loeffler's pneumonia in non-responsive respiratory cases.
Main Methods:
- High-resolution computed tomography (HRCT) revealed a spiral image of Ascaris lumbricoides within a lung cavity.
- Peripheral blood smear showed significant eosinophilia (40%).
- Serum IgE levels were elevated at 350 IU/mL.
Main Results:
- A diagnosis of Loeffler's syndrome due to Ascaris lumbricoides was confirmed.
- The patient responded successfully to a three-day course of mebendazole.
- Radiological findings were crucial for identifying the parasitic infection.
Conclusions:
- Loeffler's pneumonia should be considered in pediatric patients with persistent asthma and pneumonia symptoms, especially in developing countries.
- Radiological investigations are vital for diagnosing parasitic lung infections.
- Timely diagnosis through imaging can prevent inappropriate medication and complications.
Abstract:
A 14-year-old male child was hospitalized with complaints of a bronchial wheezing, cough, dyspnea, and sputum and a preliminary diagnosis of bronchial asthma and pneumonia. The patient was treated empirically for bronchial asthma and pneumonia, but gave neitherr clinical nor radiological response to treatment. On the high-resolution computerized tomography, a typical spiral image of Ascaris lumbricoides was identified inside a cavity in the upper lobe of the left lung with a diameter of 8x7 cm. Also,migratory pneumonic infiltrations progressing between the lower lobe and hilary region of the left lung were seen. Examination of the peripheral blood smear of the patient revealed eosinophilia (40%), while IgE was measured as 350 IU/mL. The patient was diagnosed as "Loeffler's syndrome" due to A. lumbricoides", and successfully treated with mebendazole 2x100 mg/day for three days. Loeffler's pneumonia should be considered when patients with bronchial asthma and pneumonia do not respond to specific treatment in developing countries. Radiological investigations may be available in the diagnosis of parasitic infections. In this case, early diagnosis by radiologic methods have prevented unnecessary drug use and related complications.
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