Exudative pleuritis with predominant eosinophyls

A 55-years old man was admitted to Respiratory clinic complaining od chest discomfort, dyspnea, rightside thoracic pains and recurrent cough. Sometimes the abdominal pains were present as well. He spent his last holidays6 month ago at Mediterranian sea in Spain. Chest X-ray showed basal pleural effusion of moderate quantity on right side and no changes in the lung. Thoracocentesis was performed and an pleural exudat was estimated. Cytologic smear of the pleural exudat showed elevated number of cells with predominant eosinophyls.

The differenzial diagnosis of eosinopylic pleuritis was indicated and so also the microbiologic analysis of faeces for parasites. By microscopy Strongiloides stercoralis was detected. The prolonged treatment with Thiabendasol 1500mg/day was performed for 10 days until faeces microbiology was negative and pleuritis was slowly resolved.

The case should made thinking on parasitic infection in non resolving exudative pleuritis, if the patient was on holidays in endemic area in the past.