Migrating

A 27 year old man presents with a non-productive, paroxysmal, nocturnal cough for five days associated with breathlessness and wheezing.

There is no history of chronic respiratory illness, atopy or tuberculosis. His medical, surgical, and drug histories are unremarkable.

He does not smoke or consume alcohol. He migrated from India to the United States just 4 months ago.

Initial investigations reveal a white cell count of 28,000/mm3, with an eosinophilia of 21,300/mm3. A chest x-ray reveals scattered reticulonodular infiltrates in the mid and lower zones of both lungs.

Select Relevant Investigations
Stool Microscopy

Performed

No ova or parasites seen.
Serum IgE levels

Performed

IgE: 24,020 kU/L (0-120)
Filaria specific IgG levels

Performed

Filaria specific IgG: Positive
Serology for Toxocariasis

Performed

Serology for toxocariasis: Negative

Select Relevant Management
Supplemental Oxygen
Diethylcarbamazine
Prednisolone
Ivermectin