Tropical pulmonary eosinophilic granulomatosis

　　There is sufficient evidence to show that tropical pulmonary eosinophilic granulomatosis is closely related to filarial infection. For example, most patients have a positive complement fixation test for filarial antigens in their serum, and the titer decreases after cure; in typical patients, microfilariae have been found in the liver, lungs, and lymph nodes; antifilarial drug treatment has a good effect on the disease. Some other parasitic diseases, such as roundworm, hookworm, and Anisakis infection, may also cause this disease.

　　The complications of tropical pulmonary eosinophilic granulomatosis are different depending on the onset period of the disease. In the acute stage, it is recurrent lymphangitis, lymphadenitis, and fever. In the chronic stage, it is lymphedema and elephantiasis. Severe cases may present with myocarditis, lower limb or scrotal edema, psychiatric symptoms, and even exhaustion.

　　The common clinical symptoms of tropical pulmonary eosinophilic granulomatosis include cough, wheezing, chest tightness, fatigue, anorexia, and fever, with severe cough but a lot of thick phlegm that is difficult to cough up. Sometimes, blood may be present in the sputum, and there may be asthmatic attacks. A few patients may have arrhythmias and gastrointestinal symptoms. If effective treatment is not given, the course of the disease often recurs and prolongs, and after several years, lung dysfunction may appear due to pulmonary fibrosis. Physical examination may reveal wheezing sounds in the lungs and mild enlargement of the liver, spleen, and lymph nodes. Laboratory tests show a significant increase in peripheral blood eosinophils, which may exceed 2500/mm, even higher, and IgE also increases accordingly.

　　If effective preventive measures are taken, the probability of tropical pulmonary eosinophilic granulomatosis can be effectively reduced. Below, I will introduce the preventive measures for this disease for everyone:

　　1. Prevent and eliminate mosquitoes

　　It is best to use a mosquito net during the mosquito season; when working outdoors, pay attention to apply mosquito repellent oil, mosquito repellent, and other repellents to the exposed skin, and the head can use a mosquito net made by soaking cotton thread in 701 mosquito repellent oil. Cut off the route of transmission and eliminate the breeding ground of mosquitoes.

　　2. General survey and treatment

　　In summer, conduct a general survey of people over 1 year old in the epidemic area, requiring more than 95% of the residents to accept blood collection; early detection of patients and carriers, timely cure, not only ensure people's health, but also reduce and eliminate the source of infection. In winter, treat microfilaria-positive patients or those who are microfilaria-negative but have a history of filariasis and signs.

　　3. Epidemiological monitoring

　　Strengthen the epidemiological monitoring in the areas that have reached the basic indicators for the elimination of filariasis.

　　4. Protect susceptible populations

　　In the epidemic area, use ivermectin salt therapy, add 3g of ivermectin to each kilogram of salt, an average of 16.7g of salt per person per day, containing 50mg of ivermectin, for half a year, which can reduce the positive rate of microfilaria in the population.

　　The main manifestations of tropical pulmonary eosinophilic granulomatosis are cough, wheezing, chest tightness, and fatigue, which can generally be diagnosed through the following examinations:

　　1. Pulmonary examination;

　　2. Serum immunoglobulin E (IgE);

　　3. Chest CT examination;

　　4. Chest radiography;

　　5. Routine blood tests;

　　6. Chest X-ray.

　　Patients with tropical pulmonary eosinophilic granulomatosis have no special dietary requirements, and normal diet is sufficient. Attention should be paid to a rich diet and balanced nutrition. Ensure the needs of calories, proteins, and vitamins required for normal human metabolism. Increase the intake of vegetables and fruits appropriately. In terms of health care, it is important to relax the mind, build confidence, maintain a good attitude, and actively cooperate with the doctor's treatment.

　　Ivermectin is the first-line drug for tropical pulmonary eosinophilic granulomatosis, 6-8mg/kg/d, taken orally in three divided doses, for 10-14 days, symptoms are usually relieved within a few days. Other drugs that can be used include levamisole, carbarsone, and ethacrylsalicylic acid, etc. The time required for the recovery of blood eosinophils and X-ray changes is often slower than the disappearance of clinical symptoms, taking about 1-3 months. Some patients may experience symptom exacerbation in the early stage of treatment, and prednisone can be taken for several days.