Question

Patient presents with breathlessness & wheezing. Absolute Eosinophil count is 500. Milliary pattern on CXR. Diagnosis

• A. Miliary TB
• B. Tropical pulmonary eosinophilia
• C. Bronchial asthma
• D. Hypersensitivity pneumonitis

Answer 1

The Correct Option is B

The patient presents with symptoms of breathlessness and wheezing, along with an absolute eosinophil count of 500 and a miliary pattern observed in the chest X-ray (CXR). These symptoms and findings need to be combined to arrive at a potential diagnosis.

The given options for the diagnosis are:

• Miliary TB
• Tropical pulmonary eosinophilia
• Bronchial asthma
• Hypersensitivity pneumonitis

Let’s analyze each condition:

• Miliary TB: This condition typically presents with a miliary pattern on CXR due to hematogenous spread of tuberculosis. However, it does not typically present with a high eosinophil count.
• Bronchial asthma: It is characterized by wheezing and breathlessness, but does not usually show a miliary pattern on a CXR and typically doesn't have associated elevated eosinophil counts.
• Hypersensitivity pneumonitis: This condition presents with respiratory symptoms and can cause a diffuse pattern on CXR, but it is mainly related to exposure to organic dusts and does not prominently feature elevated eosinophils.
• Tropical pulmonary eosinophilia: Caused by a reaction to filarial infections, it presents with respiratory symptoms such as wheezing and breathlessness, elevated eosinophil count, and a miliary pattern on CXR.

Based on the analysis, the combination of symptoms and findings, particularly the elevated eosinophil count and the miliary pattern on the CXR, points towards Tropical pulmonary eosinophilia as the correct diagnosis.