Thursday, September 29, 2005

Follow-up to Asthma?

This post was to show Lazar that some of my weird DDx do exist. Good pick-up by JJ and Doug.
This young patient had ample opportunity to catch some unusual organisms in her trips. I obtained a CBC with diff (just very mild anemia with normal diff - 2.5% Eos) and a serum IgE (777 - that's high). I also requested 3 consecutive stool samples. The first was negative but in the following samples there were rare Strongyloides larvae seen on the trichrome.
Strongyloides (and hookworms in general) will cause slow GI blood loss with anemia and their life cycle leads them through the lungs with wheezing. She has been started on albendazole and bronchodilators and already feels much better and has a follow-up within a few weeks. I will keep you posted.

2 comments - CLICK HERE to read & add your own!:

Arenberg said...

That is a great case Carlos, but the only reason I think we guessed parasite is becuase why the @%#$%^&?>(*&^} else would you post a routine case of asthma on a site like this? ;-)

Baleeiro said...

An why else would I spend all the time on her trips to exotic locations? :)