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Patient's CT scan of lung
Normal CT scan
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Image 15:
This young man presented with a two month history of intermittent low grade fever, dry cough, fatigue, eosinophilia (5000/碌l) and splenomegaly (16 cm), beginning several weeks after returning from a 2 month long construction project in the Dogon region of Mali. His high resolution CT scan (left) revealed a diffuse fine reticular pattern and variably sized (few mm-1 cm) ill-defined nodules. (click on image for larger version)
Diagnosis:
This is the Katayama syndrome. Three months before we saw him he remembered wading in a river and developing an itchy finely papular rash on his water-exposed legs, persisting for 48 hours after leaving the water. His cough and fever began 3-4 weeks later. Schistosoma hematobium eggs were found in the stool and his anti-Schistosoma mansoni serotiter was positive. Other cases have been described from this region.(CID 1995;20:280-5) He responded to treatment with praziquantel.
