Pulmonary ascariasis: two cases in Austria and review of the literature

Abstract

Ascariasis is the most common helminthic infection, with an estimated worldwide prevalence of 25%. The estimated mortality ranges from 0.8 to 1%. Second stage larvae pass through the intestinal wall and migrate via the portal vein system to the liver and then proceed to the lungs, where they may produce pneumonia and eosinophilia. Symptoms include wheezing, dyspnea, nonproductive cough, hemoptysis, and fever. Two cases of pulmonary ascariasis in Austrian males are reported. Both patients presented with dyspnea, nonproductive cough, fever, and eosinophilia (19 and 26%). One patient additionally had pulmonary infiltrates. Recent travel history was unremarkable in both individuals. Serology for Ascaris was positive twice in both patients, while microscopic examination of stool was negative for helminthic ova. Extensive diagnostic procedures were performed to rule out possible differentials for the patients symptoms. Both patients responded well to antiparasitic treatment with albendazole 400 mg and mebendazole 100 mg q12h for 3 days, respectively. This report highlights the importance of considering parasitic infection in patients presenting with eosinophilia and pulmonary symptoms also in Austria.