Tropical Pulmonary Eosinophilia. A 26 yr old male attended Mopd Complaining of- Productive cough x 1 month Low grade fever x 3 days Associated Wheeze and SOB. Sputum is thick, mucoid, tenacious white colored, 1/2 cup per day, non offensive smell and without Hemoptysis. Breathlessness is non-Exertional, No associated Orthopnea, PND etc. Pt is sensitive to dust,fumes, seasonal variations. No H/O chest pain, Hemoptysis, low appetite, wt loss, Diaphoresis, palpitation, Apnea, snoring, daytime sleepiness etc Non-smoker, No pet at home, occasional Alcoholic. H/O recent travel from Mumbai. No H/O HTN,DM,Thyroid disorder,CAD,COAD, CKD, Pulmonary Koch, Rheumatic disease etc. O/E Pt is C/A/C Pallor-, Cyanosis -, Clubbing-, Icterus-, Edema- No Lymphadenopathy, No Neck vein distension, No neck swelling. ENT- NAD Chest- B/L clear, air entry+ P/A - soft,BS+ CVS- S1/S2 audible CNS - No focal Neurological deficit. Dx of URTI, Allergic rhinitis and cough variant asthma was made and routine Ix was advised. Next day pt attended Mopd with reports showing- CXR PA view - NAD PFT- NAD Normal CRP- 3.6 Raised CBC- 18k Raised Eosinophil % - 49.7%. ESR- 16 Br Asthma, ABPA, Tropical pulmonary Eosinophilia , Aspergillosis, Churg Strauss, Acute Eosinophilic Pneumonia all are D/D. Diagnosis of TPE was made and pt started on conservative treatment. TPE is endemic in our country. Tropical pulmonary eosinophilia (TPE) is a syndrome of wheezing, fever and eosiniphilia seen predominantly in the Indian subcontinent and tropical areas. Pt put under follow up, asked to review after 21 days of treatment.

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Very useful sir. What conversative treatment does the patient is on now??