PMC9193837_01
: Documented eosinophil count over two-month period during patient's hospital course.
gr1.jpg
PMC9193837_01_gr1.jpg
fig0005
Initial absolute eosinophil count was within normal range, however, twelve days later, it was increased at 7.67 x 10(9)/L and twenty-three days later decreased to 2.13 x 10(9)/L. (Fig. 1).
Contrast-enhanced CT chest. A) axial image lung window showing patchy area of ground glass. opacification (yellow box). B) coronal image lung window demonstrating interlobular septal thickening, consistent with pulmonary edema (yellow circles). C, D) axial mediastinal window images showing pericardial. effusion (yellow arrows) in (C) and non-specific midly enlarged mediastinal and bilateral hilar lymph nodes. (yellow arrows) in (D).
gr2.jpg
PMC9193837_01_gr2.jpg
fig0010
Overall findings, in conjunction with an ejection fraction of 65% on echocardiogram, non-cardiogenic pulmonary edema, and pericardial effusion were favored (Fig. 2).
Bronchoalveolar lavage, Grocott-Gomori methenamine-silver (GMS) stain. A) 20x, numerous Strongyloides stercoralis larva. B) 100x, numerous Strongyloides stercoralis larva. C) 400x, single Strongyloides stercoralis larva with short buccal grove (arrow head) and prominent genital primordium (arrow).
gr3.jpg
PMC9193837_01_gr3.jpg
fig0015
Strongyloides hyperinfection (Fig. 3, Fig. 4). Stool analysis was negative for ova and parasites (O&P). She was started on Ivermectin (200 mcg/kg/day) for two weeks.