Image challenge: Beware of diagnostic anchoring - An offshore vessel welding inspector with eosinophilia and a cough productive of 'worms'

Clin Infect Pract. 2021 Nov:12:100105. doi: 10.1016/j.clinpr.2021.100105.

Abstract

A 38-year old male was referred from an Acute Medical Unit to a regional Tropical Infectious Disease Unit with a seven-week history of dyspnoea, wheeze and cough reportedly productive of worms. The patient had taken photographs of the expectorated substance which allowed macroscopic examination by a consultant in infectious diseases. Fresh samples were also sent for histological examination. Initial investigations showed a prominent eosinophilia of 2.5 × 109/ml (0.0-0.4 × 109/ml).

Keywords: Allergic bronchopulmonary aspergillosis; Asthma; Bronchial casts; Eosinophilia; Travel; Worms.

Publication types

  • Case Reports