Tropical pulmonary eosinophilia misdiagnosed as miliary tuberculosis: A case report and literature review

Tropical pulmonary eosinophilia is prevalent in the tropical and subtropical regions of the world. It is an occult form of human filariasis and results from an exaggerated immune response to filarial parasites Wuchereria bancrofti and Brugia malayi. Tuberculosis is prevalent in our country and may mimic almost any pulmonary disease on chest skiagram. Here we describe a patient with acute chest symptoms and micro-nodular opacity over chest roentogenogram, diagnosed as miliary tuberculosis and treated accordingly. Actually he was suffering from tropical pulmonary eosinophilia and showed response to combined diethylcarbamazine and corticosteroid therapy. This case serves as a reminder that tropical pulmonary eosinophilia may be wrongly diagnosed as miliary tuberculosis if one rely solely on a chest X-ray with micronodular opacities. We also stress on early diagnosis and treatment of this condition to avoid unfavorable outcomes.