Pseudoparasitic pneumonia after bone marrow transplantation.

We present a female patient from Somalia with an acute lymphoblastic leukemia, who received an allogeneic bone marrow transplantation (BMT) and developed several periods of moderate to severe pulmonary symptoms that were accompanied by pulmonary infiltrates and peripheral blood eosinophilia. After several recurrences an open lung biopsy was performed, which initially gave rise to the diagnosis parasitic infection. Later on this diagnosis was questioned and it was suggested that the structures were artifacts that might have been aspirated. Nevertheless, after the immediately given antihelminthic treatment no peripheral blood eosinophilia occurred anymore, but at that point of time pulmonary function was already severely hampered and eventually led to a lethal complication. With the worldwide increasing migration from Third World countries with a high prevalence of parasitic infections, more patients will receive immunosuppressive therapies in countries less familiar with parasites. This may complicate diagnostic procedures, prevent early recognition and delay adequate treatment. Specific screening for opportunistic parasitic infections of the population at risk before BMT and a great awareness for these infections is strongly recommended.

Pleuropulmonary paragonimiasis in a Laotian immigrant to Australia.

A case of pleuropulmonary paragonimiasis that mimicked reactivation of pulmonary tuberculosis, pneumonia, and neoplasm occurred in a Laotian immigrant to Australia. The key to the diagnosis of this condition is awareness of the disease in persons from this region. The diagnosis was supported by enzyme-linked immunosorbent assay testing. The patient was successfully treated with praziquantel.

[Pulmonary mycoses and parasitosis]. / Les mycoses et parasitoses pulmonaires.

Lungs can be the target of many fungal parasitic organisms. Some of them are specific to the lung (Pneumocystis); while others will migrate there in the course of their life cycle (Ascaris) or be caught in it (Paragonimus, Echinococcus). Sometimes, they also generate hypersensitivity reactions (fungi). In making a diagnosis one has to consider the present state of health or the disease history of the patient. A great number of parasites or mycetes are opportunist agents found in immuno-compromised patients. The epidemiological investigation giving details of a trip, even a long time ago, in a tropical region allows the suspicion of an imported parasitosis or an exotic mycosis. At present, we have on one hand, the mixing of populations, and on the other hand, many immuno-compromised situations which has given rise to a renewed interest in fungal and parasitic lung diseases.