Tuberc Respir Dis TRD Tuberculosis and Respiratory Diseases 1738-3536 2005-6184 The Korean Academy of Tuberculosis and Respiratory Diseases 10.4046/trd.2007.62.1.19 Original Article The Characteristics of Eosinophilc Lung Diseases Cause by Toxocara Canis Larval Infestation Kim Yu Jin M.D. 1 Kyung Sun Young M.D. 1 An Chang Hyeok M.D. 1 Lim Young Hee M.D. 1 Park Jung Woong M.D. 1 Jeong Seong Hwan M.D. 1 Lee Sang Pyo M.D. 1 Choi Dong Chull M.D. 2 Jeong Young Bae M.D. 3 Kang Shin Yong M.D. 4 Department of Internal Medicine, Gachon University, Gil Medical Center, Korea. Department of Internal Medicine, Sungkyunkwan University, Korea. Department of Parasitology, Cheju National University, Korea. Department of Parasitology, Chung Ang University, Korea. Address for correspondence: Sang Pyo Lee, M.D. Department of Internal Medicine, Gachon Medical School Gil Medical Center, Guwol-1-dong, Namdong-gu, Incheon, 405-760, Korea. Tel: 032-460-3209, Fax: 032-469-4320, drsplee@gachon.ac.kr 01 2007 31 01 2007 62 1 19 26 29 11 2006 02 01 2007 Copyright © 2007 The Korean Academy of Tuberculosis and Respiratory Diseases 2007 Background

Toxocariasis is a common cause of eosinophilia and eosinophilic lung disease in Korea. We analyzed the characteristics of eosinophilic lung disease in toxocariasis.

 Method

One hundred and forty one patients with eosinophilia caused by a toxocara larval infection were evaluated from September 1, 2001 through March 30, 2006. The plain chest x-ray, chest CT(computed tomography), and bronchoalveolar larvage(BAL) were examined. A diagnosis of toxocariasis was made by ELISA using that secretory-excretory antigen from the T. canis larvae.

 Results

Toxocarial eosinophilic lung diseases was diagnosed in 32 out of 141 patients. Ground glass attenuation was the main feature on the CT scans in 23 out of 141 patients (71.9%). Thirteen patients (40.6%) had a random in zonal distribution on CT. Pleural effusion was observed in 9 patients (28.1%). Twenty eight patients (87.5%) complained of respiratory symptoms. Eleven patients (34.4%) had gastrointestinal symptoms and 12 patients (37.5%) had liver infiltration.

 Conclusions

The most common findings of the chest CT in patients with toxocariasis was a randomly distributed ground grass attenuation. A toxocara infection should be considered in a differential diagnosis of patients who exhibit pulmonary infiltration with eosinophilia in Korea.

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(A) Chest X-ray from 27 year-old male patient with toxocariasis showing numerous, poorly defined multiple patchy increased densities area scattered in both upper and lower lobe. 1(B) After 1months later, Chest X-ray reveals nealry disappered numerous, poorly defined multiple patchy increased densities area scattered in both upper and lower lobe (C) Chest computed tomography scan from 47 year-old female patient with toxocariasis showing multifocal patch or ill defined nodular ground glass opacity in right lung and left upper lobe. (D)After 5months later, Chest computed tomography scan reveals nearly disappered multifocal patch or ill defined nodular ground glass opacity in right lung and left upper lobe.

Clinical characteristics of 32 toxocariasis patients with eosionphilic lung disease

*mean±standard deviation

†PB: Peripheral blood

‡BAL: Bronchoalveolar larvage

Clinical signs and symptoms of 32 toxocariasis patients with eosionphilic lung disease

HRCT findings of eosinophilic lung disease in 32 toxocariasis patients

GGA: ground glass attenuation