Tachypnea, Fever and Eosinophilia

  • Kevin S. Gipson
  • Ryan H. Avery
  • Luke A. WallEmail author

Practical Points

  • Löffler syndrome is a helminth-associated eosinophilic pneumonitis which occurs when helminths transmigrate through the lung parenchyma and airways, provoking a marked eosinophil-mediated inflammatory response.

  • The clinical picture is a constellation of transient pulmonary infiltrates on CXR, respiratory symptoms including cough and hypoxemia, and peripheral blood and pulmonary eosinophilia.

  • Supportive care including supplemental oxygen and inhaled bronchodilators is helpful in acute management of Löffler-associated respiratory symptoms.

  • Anthelmintic treatments may be used in particularly severe or refractory cases of Löffler syndrome, though the condition is generally self-limited.

  • Strongyloides co-infection should be ruled out in patients who have risk factors for helminth exposure before the use of systemic steroids, particularly in otherwise immunosuppressed patients to avoid the potential risk of a disseminated hyperinfection syndrome.

  • The same cautionary statement applies to monoclonal antibodies which are designed to inhibit IgE or eosinophils.

  • Helminth infection should be considered in the differential diagnosis for asthma, eosinophilia, or elevated IgE, even in developed countries.


Löffler syndrome Helminth Strongyloides Asthma 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Kevin S. Gipson
    • 1
  • Ryan H. Avery
    • 2
  • Luke A. Wall
    • 3
    Email author
  1. 1.Division of Pediatric Pulmonology, Department of Pediatrics, Massachusetts General HospitalHarvard Medical SchoolBostonUSA
  2. 2.Department of Pathobiological SciencesLouisiana State University School of Veterinary MedicineBaton RougeUSA
  3. 3.Section of Allergy Immunology, Department of Pediatrics, Children’s HospitalLouisiana State University School of MedicineNew OrleansUSA

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