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Semin Respir Crit Care Med 2006; 27(2): 171-184
DOI: 10.1055/s-2006-939520
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Parasitic Pulmonary Eosinophilia

Rajinder K. Chitkara1 , Ganesh Krishna1
  • 1Division of Pulmonary and Critical Care Medicine, Veterans Affairs Palo Alto Healthcare System, Stanford University School of Medicine, Palo Alto, California
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Publication History

Publication Date:
13 April 2006 (online)

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ABSTRACT

Parasitic infections, although common in tropical and subtropical regions, are prevalent worldwide because of changing immigration patterns and in international travel. The burden of worm infection is enormous and the intensity of infection is usually high among the poor and in immunocompromised individuals. Pulmonary eosinophilia occurs in almost all metazoan infections. In the Western world, the most common infections are caused by Strongyloides, Ascaris, Toxocara, and Ancylostoma species. Most of the nematodes multiply within the human host and cause pulmonary eosinophilia during larval migration through the lungs. Despite larval migration through the lungs, there is usually no permanent lung damage. The result is an increased number of eosinophils in the airways or lung parenchyma with or without peripheral eosinophilia. Loffler's syndrome, visceral larva migrans, and tropical pulmonary eosinophilia are the most common infections that cause pulmonary eosinophilia. The most serious parasitic eosinophilic lung disease is tropical pulmonary eosinophilia, a disorder caused by the filarial worms Wuchereria bancrofti and Brugia malayi, in which cases have typically been reported to masquerade acute or refractory bronchial asthma. Increasing awareness, newer diagnostic techniques, preventative measures, and antiparasitic drugs are important in reducing the worldwide morbidity and mortality from parasitic helminths and protozoa. This review focuses on common and some uncommon causes of pulmonary parasitic eosinophilia and their manifestations, diagnosis, and management.

KEYWORDS

Eosinophilia - pulmonary - infection - parasite

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Rajinder K ChitkaraM.B. M.D. 

Division of Pulmonary and Critical Care Medicine (111P)

3801, Miranda Ave., Bldg. 100, F2-142, Palo Alto, CA 94304

Email: rkc@stanford.edu

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