A Case of Chronic Cough with Progressive Breathlessness in a 32 Year-old Male Health Worker – Tuberculosis?, Allergic Bronchitis?, Asthma?

Introduction: Although tuberculosis is hyper-endemic in India and is responsible for a huge proportion of respiratory morbidity, adequate workup should be conducted to rule out other differential diagnosis wherever applicable.
Case Report: A 32 year old male health worker was suffering from productive cough and gradually increasing breathlessness since three months. The investigations conducted were a sputum analysis and a chest x-ray, both of which were normal and hence he was treated as a case of allergic bronchitis. Subject presented to us after three months with no relief. We further investigated him and found severe eosinophilia in the peripheral blood, a positive anti-filarial antibody and a negative triple stool test for ova and parasites. He was treated with diethylcarbamazine and albendazole+ivermectin combination. The patient responded well and had no complaints at the end of the 4 week treatment.
Discussion and Conclusion: The subject should have been evaluated by conducting a basic investigation like a complete blood count. Delay in treatment of cases of tropical pulmonary eosinophilia can lead to permanent respiratory morbidity.