Associate Professor, Doctor Chu Thi Ha from the Respiratory Unit, Department of General Internal Medicine, Tam Anh General Clinic District 7, diagnosed Mr. Tien with pre-diabetes, elevated liver enzymes, and inflammation. A low-dose CT scan of his lungs revealed Löffler's syndrome. This condition is a form of eosinophilic pneumonia, often caused by parasitic infections (such as roundworm or Strongyloides), and can also be linked to drug allergies or respiratory allergens. Mr. Tien, a farmer who quit smoking five years ago, underwent parasite testing, which confirmed a Strongyloides infection.

Doctor Ha explained the CT lung scan images to Mr. Tien. Photo: Tam Anh General Hospital

Doctor Ha elaborated that Strongyloides infection is common in tropical climates, including Vietnam. Strongyloides larvae primarily enter the body through open wounds or skin abrasions. They then travel through the bloodstream to the lungs, penetrate the alveoli, and finally parasitize the small intestine. During the larval migration through the lungs, patients may experience a dry cough, difficulty breathing, pulmonary infiltration, and eosinophilia. This mechanism is what causes Löffler's syndrome.

Strongyloides worms can persist in a patient's body for a long time, leading to a chronic illness that can last for many years without needing re-infection from external sources. In immunocompromised individuals, Strongyloides infection can progress to a hyperinfection or disseminated syndrome, causing severe complications in the lungs, digestive system, and sepsis. Given Mr. Tien's pre-diabetic condition and risk of immunosuppression, early treatment was essential. He received treatment with antibiotics and anti-Strongyloides medication. After three days, his condition improved by 70%, with no more wheezing or difficulty breathing.

Doctor Ha advises that persistent, recurring respiratory symptoms, even after multiple courses of treatment, should not be ignored. Regular health check-ups and taking recommended deworming medication can help detect potential pathogens such as parasitic infections, immune disorders, or atypical lung damage early.

Nhat Thanh

*Patient's name has been changed