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The history of the farmer’s eating habits and diet had to be taken into consideration and questioned. It was found that he had a history of eating raw meat, with frequent consumption of uncooked dog and cow liver. The level of eosinophil cationic protein was 12.50 µg/l and the bronchoalveolar lavage fluid contained 20.8% monocytes, 4.6% neutrophils, 69.4% lymphocytes and 5.2% eosinophils. An open lung biopsy revealed extensive eosinophilic infiltration and a larval nematode near the pleural surface (fig 1). An ELISA with the larval excretory–secretory antigen of Toxocara canis was positive. He was treated with albendazole at 13 mg/kg/day (800 mg/day) for 6 weeks. After 6 months, he had improved chest radiographs and no respiratory symptoms.
Figure 1 The subpleural granuloma associated with chronic organising pneumonia and a multifocal eosinophilic microabscess reveals Toxocara larva (inset) with a smooth and thin cuticle (scale bar: | |||||||||
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Thorax 2009 64: 756.[Extract] [Full Text] [PDF]
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