PULMONARY FILARIASIS

Abstract

The authors report a case of a native from a South Pacific filarial-endemic island, in whom a diagnosis of pulmonary filariasis was made. Cough, blood-stained sputum and night sweats were the presenting symptoms. Roentgenographic examination revealed a diffuse shadow in the left lower lobe with a small ill-defined shadow in the right upper lobe. These shadows cleared at the end of 5 weeks, leaving fanned zones of hard linear densities. Sputum examinations revealed numerous microfilariae of Wuchereria bancrofti, with many eosinophiles. Peripheral blood examns. showed numerous microfilariae with a 28% eosinophilia. A skin test, utilizing an antigen of Dirofilaria immitis, gave a positive reaction to a titre of 1:8000 and 1:16,000. Other lab. examns. were essentially negative. The findings of eosinophilia and microfilariae in the sputum, associated with a positive skin test in high titre, suggest an acute filarial reaction involving the bronchial lymphatics. It is further believed that the edema and eosino-philic infiltration of these lymphatics are responsible for the transitory roentgenographic findings. In view of the development of the disease in American troops, it is suggested that filariasis be considered in the future in the differential diagnosis of transitory pulmonary infiltrations.