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Löeffler's syndrome

Authors:
Renata Spener at Federal University of Amazonas
Renata Spener
Izabella Safe
Izabella Safe
Izabella Safe
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Djane Clarys Baia-da-Silva
Djane Clarys Baia-da-Silva
Djane Clarys Baia-da-Silva
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Marcus Vinicius Guimarães de Lacerda
Marcus Vinicius Guimarães de Lacerda
Marcus Vinicius Guimarães de Lacerda
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Medical
Imagery
Löeffler’s
syndrome
Löeffler
syndrome
(LS)
is
a
transient
respiratory
illness
associated
with
peripheral
eosinophilia
(PE)
and
radiographic
infiltrates
(Meta-jevtovic
et
al.,
2008).
Ascaris
lumbricoides
is
the
most
common
cause
(Celandroni
et
al.,
2002).
We
report
a
case
of
a
33-year-old
man
who
presented
with
a
four-day
history
of
fever,
dry
cough
and
mild
dyspnea
in
a
Brazilian
Amazon
emergency
department.
Lung
auscultation
was
normal.
Chest
radiograph
showed
bilateral
pulmonary
infiltrations
(BPI)
with
mixed
patterns
(Figure
1A).
High-resolution
CT
revealed
bilateral
scattered
ground-glass
opacities
and
peripheral
consolidation
(Figure
1B).
Laboratory
data
showed
31,500
white
blood
cells
per
microliter
with
65%
of
eosinophils.
HIV
serologic
test,
blood
culture,
parasitological
stool
microscopy
using
Hoffman,
Pons
and
Janer,
and
Ritchie
methods
were
negative.
The
patient
was
treated
with
antibiotics
and
prednisone.
48
h
later,
the
patient
presented
improvement.
After
three
months
of
follow-up,
the
patient
had
gastrointestinal
symptoms
and
Hoffman,
Pons
and
Janer,
and
Ritchie
methods
identify
A.
lumbricoides
eggs.
There
was
clinical
improvement
after
treatment
with
mebendazole.
LS
is
character-
ized
by
absence
or
presence
of
moderate
symptoms
and
temporal
BPI
that
may
spontaneously
improve
(Celandroni
et
al.,
2002).
It
should
be
considereda
differentialdiagnosis
in
case
of
fever,
asthma-
like
symptoms,
BPI
and
living
in
endemic
areas
for
parasitic
infections,
such
Brazilian
Amazon
(Ekin
et
al.,
2016).
Effective
treatment
may
be
achieved
with
corticosteroids
(Akuthota
and
Weller,
2012)
and
the
appropriate
use
of
anthelmintic
drugs
is
indicated
(Vijayan,
2008).
Conflict
of
interest
On
behalf
of
all
authors,
the
corresponding
author
states
that
there
is
no
conflict
of
interest.
Funding
source
There
is
no
funding
source.
Ethical
approval
Not
applicable.
References
Akuthota
P,
Weller
PF.
Eosinophilic
pneumonias.
Clin
Microbiol
Rev
2012;25
(October
(4)):649–60.
Celandroni
A,
Cinquanta
L,
Lagrasta
UE,
Caprai
S.
Loeffler
syndrome
and
Mycoplasma
pneumonitis.
Minerva
Pediatr
2002;54:243–7.
Ekin
S,
Sertogullarindan
B,
Gunbatar
H,
Arisoy
A,
Yildiz
H.
Loeffler’s
syndrome:
an
interesting
case
report.
Clin
Respir
J
2016;10(January
(1)):112–4.
Meta-jevtovic
I,
Tomovic
MS,
Mojsilovic
S,
Petrovic
M.
Nonallergic
simple
eosinophilic
pneumonia—Löffler
syndrome—a
case
report
study.
Med
Pregl
2008;61:643–6.
Vijayan
VK.
Tropical
parasitic
lung
diseases.
Indian
J
Chest
Dis
Allied
Sci
2008;50
(January–March
(1)):49–66.
Figure
1.
Chest
radiograph
(A)
and
high-resolution
CT
(B)
of
the
lungs.
A.
Bilateral
infiltrate
with
mixed
patterns.
B.
Bilateral
scattered
ground-glass
opacities
and
peripheral
consolidation.
https://doi.org/10.1016/j.ijid.2019.09.011
1201-9712/©
2019
The
Author(s).
Published
by
Elsevier
Ltd
on
behalf
of
International
Society
for
Infectious
Diseases.
This
is
an
open
access
article
under
the
CC
BY-NC-ND
license
(http://creativecommons.org/licenses/by-nc-nd/4.0/).
International
Journal
of
Infectious
Diseases
89
(2019)
79–80
Contents
lists
available
at
ScienceDirect
International
Journal
of
Infectious
Diseases
journal
home
page:
www.elsevier.com/locat
e/ijid
Renata
Spener
a,b
Izabella
Safe
a
Djane
Clarys
Baia-da-Silva
a
Marcus
Vinicius
Guimarães
de
Lacerda
c
Marcelo
Cordeiro-Santos
a,b,
*
a
Fundação
de
Medicina
Tropical
Dr.
Heitor
Vieira
Dourado,
Manaus,
Amazonas,
Brazil
b
Universidade
do
Estado
do
Amazonas,
Manaus,
Amazonas,
Brazil
c
Fundação
de
Medicina
Tropical
Dr.
Heitor
Vieira
Dourado,
Instituto
Leônidas
e
Maria
Deane,
Fiocruz,
Amazônia,
Brazil
*
Corresponding
author
at:
Fundação
de
Medicina
Tropical
Dr.
Heitor
Vieira
Dourado,
Av.
Pedro
Teixeira,
25,
CEP:
69040-000,
Manaus,
AM,
Brazil.
E-mail
addresses:
renataspenergomes@gmail.com
(R.
Spener),
izabellasafe@gmail.com
(I.
Safe),
djane.claryss@gmail.com
(D.
Baia-da-Silva),
marcuslacerda.br@gmail.com
(M.
de
Lacerda),
marcelocordeiro@uea.edu.br
(M.
Cordeiro-Santos).
Corresponding
Editor:
Eskild
Petersen,
Aarhus,
Denmark
Received
24
July
2019
Received
in
revised
form
4
September
2019
Accepted
9
September
2019
80
R.
Spener
et
al.
/
International
Journal
of
Infectious
Diseases
89
(2019)
79–80
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