Eosinophilia with respiratory symptoms

There may be an incidental combination of eosinophilia and respiratory symptoms (no causal relationship). A cosmopolitan disease (e.g. asthma) may occasionally be involved, but there is often an exotic cause in travellers with recent onset respiratory problems and eosinophilia.


Among the exotic causes we mention paragonomiasis (lung flukes), Katayama syndrome (acute schistosomiasis) and occult filariosis (Weingarten syndrome or tropical pulmonary eosinophilia syndrome). Migration of various nematode larvae (Ancylostoma, Strongyloides, Ascaris, Toxocara) through the lung can result in Loeffler's syndrome. Strongyloides infections tend to be very persistent (beware of steroids and HTLV-1 infections). Chronic schistosomiasis can also cause pulmonary lesions and eosinophilia. Pulmonary echinococcosis tends to be asymptomatic although narrowing of a bronchial lumen can occur due to external compression.


Asthma can be triggered by hypersensitivity to cockroaches (Blatta sp, Blatella sp, Periplaneta sp) and other insects. Inhalation of urticarial (stinging) hairs of certain caterpillars can provoke acute airway symptoms.

Category: Medicine Notes