Tropical Pulmonary Eosinophilic Infiltration Syndrome
Introduction
Introduction to tropical pulmonary eosinophilic infiltration Tropical pulmonary eosinophilic infiltration, or tropical alealeosinophilia, also known as Weingarten syndrome, is mainly associated with filariasis infection, more men than women, more common in young adults. The disease occurs mostly in the area where the silkworm is endemic. The patient has symptoms such as paroxysmal cough and asthma, and the peripheral blood eosinophils are significantly increased. basic knowledge The proportion of illness: the incidence rate is about 0.005% - 0.0007% Susceptible people: more men than women, more common in young adults. Mode of infection: mosquito bites Complications: acute lymphangitis acute lymphadenitis lymphedema myocarditis
Cause
Causes of tropical lung eosinophilic infiltration
There is sufficient evidence to show that this disease is closely related to the infection of the filariasis. For example, the serum of the majority of the patients is positive for the complement fixation test of the filarial antigen, and the titer decreases after the cure. In typical patients, the liver, lung, and lymph nodes Microfilaria has been found in the inside; it has good effects in treating this disease with anti-filaria drugs, and some other parasitic diseases such as aphids, hookworms, and aphid infections may also cause this disease.
The lung parenchyma has diffuse histiocytic cells and eosinophil infiltration, which can form eosinophilic abscess. It has been reported that microfilariae and its residue are found in the center of the lung lesion, and the advanced lesion may be fibrotic and cause lung function damage.
Prevention
Tropical lung eosinophilic infiltration prevention
(1) Anti-mosquito and mosquito killing
Cut off the means of transmission and eliminate mosquito breeding grounds. It is best to use mosquito nets during the mosquito season; when working outdoors, pay attention to the skin on the exposed parts such as anti-mosquito oil, mosquito repellent and other repellents. The head can be impregnated with 701 anti-mosquito net made of cotton. .
(2) census
In the summer, a census of people over 1 year old in the epidemic area requires more than 95% of the residents to receive blood collection; early detection of patients and worms, timely cure, not only to ensure the health of the people, but also to reduce and eliminate the source of infection. In the winter, the microfilariae-positive or microfilaria-negative but with a history and signs of filariasis were treated.
(3) Epidemiological surveillance
Strengthen epidemiological surveillance of areas where basic filariasis indicators have been eliminated. Pay attention to the monitoring work:
1Review and re-examine the original positive patients; re-investigate and repair the unexamined patients; strengthen the management of the floating population, find the patients, and treat them in time until they turn negative.
2 Strengthen the mosquito-borne surveillance of blood-positive households and find that infected mosquitoes, that is, focus on infected mosquitoes, expand blood tests and kill mosquitoes to surrounding people to remove epidemic spots and prevent further spread.
(4) Protect susceptible populations
In the endemic areas, the sea group raw salt therapy is used. Each kilogram of salt is mixed with seaweed 3g, with an average of 16.7g of salt per person per day, containing 50mg of sea group, which can reduce the positive rate of microfilaria in the population.
Complication
Complications of tropical lung eosinophilic infiltration Complications acute lymphangitis acute lymphadenitis lymphedema myocarditis
The acute phase is recurrent lymphangitis, lymphadenitis and fever. The chronic phase is lymphedema and elephantiasis. In severe cases, myocarditis, lower extremity or scrotal edema, mental symptoms and even exhaustion may occur.
Symptom
Symptoms of tropical lung eosinophilic infiltration Common symptoms Low fever, lung snoring, lungs, smear, dryness and wetness... Lymph node enlargement
Common clinical symptoms include cough, wheezing, chest tightness, fatigue, anorexia and fever, coughing is severe, but phlegm is sticky, not easy to cough up, sometimes with blood in the sputum, may have asthma-like attacks, a few patients may have arrhythmia and digestion Systemic performance, if effective treatment is not given, the course of the disease often repeats and repeats. After several years, pulmonary dysfunction may occur due to pulmonary fibrosis. Physical examination may reveal pulmonary wheezing and mild liver, spleen, lymphadenopathy, laboratory Examination of peripheral blood eosinophils increased significantly, can exceed 2500/mm3, or even higher, and IgE increased accordingly.
The chest X-ray showed miliary or blurred shadows, and the middle and lower lung fields were distributed on both sides. After treatment, the X-ray abnormalities of the lungs could disappear quickly, but chronic patients often left pulmonary interstitial fibrosis.
Examine
Examination of tropical pulmonary eosinophilic infiltration
The chest X-ray showed miliary or blurred shadows, and the middle and lower lung fields were distributed on both sides. X-ray abnormalities in the lungs can quickly disappear after treatment. However, chronic patients often have pulmonary interstitial fibrosis. In addition to eosinophilic pneumonia, the lesions are extremely extensive, involving the small intestine, liver, spleen, mesentery, tonsils, brain and bone marrow. Pay attention to check blood routine, urine routine, liver function, kidney function, immune system examination, etc.
Diagnosis
Diagnosis and diagnosis of tropical pulmonary eosinophilic infiltration
Sometimes clinical manifestations are easily misdiagnosed as bronchial asthma, and may be confused with other PIEs. A differential diagnosis can be made by using the rapid diagnosis of sea group biomedical diagnosis. High fever, coma, headache, diarrhea, cough, convulsions, and hemorrhagic rash appear. They die within 1 to 2 days after onset. At the time of autopsy, in addition to the above-mentioned lesions, local eosinophilic abscesses such as skin, lung, liver, spleen and cervical lymph nodes were found in some cases. Pay attention to the identification.
