Pulmonary toxocariasis mimicking invasive aspergillosis in a patient with ulcerative colitis

Korean J Parasitol. 2014 Aug;52(4):425-8. doi: 10.3347/kjp.2014.52.4.425. Epub 2014 Aug 29.

Abstract

A 45-year-old-male who had underlying ulcerative colitis and presented with fever and dry cough. Initially, the patient was considered to have invasive aspergillosis due to a positive galactomannan assay. He was treated with amphotericin B followed by voriconazole. Nevertheless, the patient deteriorated clinically and radiographically. The lung biopsy revealed eosinophilic pneumonia, and ELISA for Toxocara antigen was positive, leading to a diagnosis of pulmonary toxocariasis. After a 10-day treatment course with albendazole and adjunctive steroids, the patient recovered completely without any sequelae. Pulmonary toxocariasis may be considered in patients with subacute or chronic pneumonia unresponsive to antibiotic agents, particularly in cases with eosinophilia.

Keywords: Toxocara canis; aspergillosis; eosinophilia; respiratory disorder; toxocariasis; ulcerative colitis.

Publication types

  • Case Reports

MeSH terms

  • Albendazole / therapeutic use
  • Animals
  • Anthelmintics / therapeutic use
  • Anti-Inflammatory Agents / therapeutic use
  • Antigens, Helminth / analysis
  • Colitis, Ulcerative / complications*
  • Diagnosis, Differential
  • Enzyme-Linked Immunosorbent Assay
  • Humans
  • Lung / pathology
  • Lung Diseases, Parasitic / diagnosis*
  • Lung Diseases, Parasitic / pathology*
  • Male
  • Middle Aged
  • Pulmonary Aspergillosis / diagnosis
  • Pulmonary Aspergillosis / pathology
  • Steroids / therapeutic use
  • Toxocara / isolation & purification*
  • Toxocariasis / diagnosis*
  • Toxocariasis / pathology*
  • Treatment Outcome

Substances

  • Anthelmintics
  • Anti-Inflammatory Agents
  • Antigens, Helminth
  • Steroids
  • Albendazole