A CASE OF LOEFFLER'S SYNDROME MIMICKING PULMONARY TUBERCULOSIS - AN UNUSUAL PRESENTATION

Loeffler's syndrome is a clinical syndrome characterised by mild respiratory symptoms, peripheral eosinophilia, elevated total IgE and transient migratory pulmonary infiltrates. SCARIS LUMBRICOIDES is a common parasitic infestation in developing countries. Immune hypersensitivity to ascaris is the likely cause. It affects all age groups usually self limited resolves within two weeks. Ascaris larva can be found in sputum or gastric aspirate. Stool examination for ova and parasites is positive only after eight weeks of respiratory symptoms. A 55 years old male presented with complaints of cough with expectoration, dyspnea,fever for fifteen days. On examination bilateral wheeze.Past history of similar complaints six years back. For that he was diagnosed as smear negative pulmonary tuberculosis and treated with empirical ATT. Now his sputum for AFB is negative during the course of advanced investigations, We measured peripheral eosiniphilia, transient migratory pulmonary infiltrates in CT chest, high level of total IgE and observed ASCARIS LUMBRICOIDES eggs during stool examination. The patient was given a diagnosis of Loeffler's syndrome and treated with mebendazole 100 Mg BD for three days to prevent gastrointestinal manifestations.