Dr. Wink writes:
Going for a Personal Record of two right guesses in a row, I have to go for paragonamiasis causing hemoptysis and a lung cavity. Thanks, as always, to Daniel for clinical acumen and content; Vincent for his insights that cover all of biology; and Dixon for his experience, perspective and graciousness.
Wink Weinberg, Atlanta
I am neither a biologist nor an MD, but here is my uneducated, or shall I say, twip-educated guess.
First, eosinophilia just tells us that it is a parasitic infection, so we need to rely on something else.
Second, with the coughing-up-blood (aka hemoptysis) manifestation persisting for a long time the young lady could have had one of the following.
Pros: (1) extremely common; (2) penumothorax/air pockets; fever;
Cons: (1) the pulmonary effects disappear after a few weeks.
(2) after 2-3 months eggs are present in the stool (i thought stool was clean).
Pros: (1) common in East Asia, (2) infection may persist for years;
Cons: not sure about the lung manifestation.
Hydatiosis caused by tapeworms of the Echinococcus type
Pros: common ; leads to a single of multiple lung cysts;
Cons: (1) cystic form starts with liver , – no symptoms;
(2) alveolar echinococcosis is rarely diagnosed in humans.
(3) usually no fever is reported
Pros: dogs everywhere,
Contra: coin lesions, not sure the coin lesion is an air pocket; (2) unlikely for India.
Even though I gravitate to the ascaris diagnosis based on Daniel’s ‘air pocket’ hint, and ignore his ‘dogs everywhere’, – I have to say that this judgement is beyond the resolution of my mental microscope.
Love your podcast above all other podcasts.
Best regards from La Jolla,