• A rare, but well recognised, syndrome characterised by pulmonary interstitial infiltrates and marked peripheral eosinophilia

• caused by Wuchereria bancrofti, a filarial infection. It occurs most frequently in India and Southeast Asia.

• also?? Brugia malayi, Burgia timori (filaria worms)

• Microfilariae (larvae) take up residence in the lung tissue, hindering respiration and causing chest pain as the disease progresses

Clinical

• Cough

• Asthma attacks (common differential in nonendemic countries)

• Splenomegaly

Differential diagnosis

• Tuberculosis

• Asthma

• Coughs related to roundworms (Löffler's syndrome)

• 
  

• Chronic symptoms may delay the diagnosis by up to five years.^[5] Early recognition and treatment with the antifilarial drug, diethylcarbamazine, is important, as delay before treatment may lead to progressive interstitial fibrosis and irreversible impairment.^[7]

• The condition of marked eosinophilia with pulmonary involvement was first termed tropical pulmonary eosinophilia in 1950.^[8]

• The syndrome is caused by a distinct hypersensitive immunological reaction to microfilariae of W. bancrofti and Brugia malayi.^[7][9] However, only a small percentage (< 0.5%)^[10] of the 130 million people globally who are infected with filariasis apparently develop this reaction. The clearance of rapidly opsonised microfilariae from the bloodstream results in a hypersensitive immunological process and abnormal recruitment of eosinophils, as reflected by extremely high IgE levels of over 1000 kU/L.^[7][11]

• The typical patient is a young adult man from the Indian subcontinent.^[9]

• https://en.wikipedia.org/wiki/Tropical_eosinophilia