Korean J Parasitol.  2014 Aug;52(4):425-428. 10.3347/kjp.2014.52.4.425.

Pulmonary Toxocariasis Mimicking Invasive Aspergillosis in a Patient with Ulcerative Colitis

• Park EJ
• Song JY
• Choi MJ
• Jeon JH
• Choi JY
• Yang TU
• Hong KW
• Noh JY
• Cheong HJ
• Kim WJ

• KMID: 1792204
• DOI: http://doi.org/10.3347/kjp.2014.52.4.425

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.

Keyword

Toxocara canis; toxocariasis; eosinophilia; respiratory disorder; aspergillosis; ulcerative colitis

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/*pathology
Male
Middle Aged
Pulmonary Aspergillosis/diagnosis/pathology
Steroids/therapeutic use
Toxocara/*isolation & purification
Toxocariasis/*diagnosis/*pathology
Treatment Outcome
Albendazole
Anthelmintics
Anti-Inflammatory Agents
Antigens, Helminth
Steroids