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Case No : 1297 Date 2022-08-29

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  • Courtesy of Eun Young Kim, Hee Young Lee / Gachon University Gil Medical Center
  • Age/Sex 55 / M
  • Chief ComplaintCough Nutrition history: seasoned raw meat of wild goose ingestion (4 weeks ago)
  • Figure 1
  • Figure 2
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  • Figure 4

Diagnosis With Brief Discussion

Diagnosis
Toxocariasis
Radiologic Findings
The chest CT scans show multiple ill-defined nodules and nodular consolidations with surrounding ground glass opacity at both lungs. These nodules show peripheral and random distribution. There is a small amount of pleural effusion on both sides. The patient had a history of eating raw liver of wild goose four weeks ago. Peripheral eosinophilia (blood eosinophil count > 500/
Brief Review
Chops of raw cow liver is one of the popular dishes in Korea, served in meat restaurants or buffet restaurants, sometimes along with chops of raw cow meat. Some people believe that raw liver or raw meat is good for health, particularly the raw liver for eyesight. In our study population, about 2/3 (64.7%, 97 of 150) of adults had an experience of ingestion of raw cow liver. In the Korean society, some people eat chops of raw cow liver frequently when they dine at meat restaurants. Not infrequently, raw livers of chickens, goats, pigs, ducks, geese, or rabbits are also consumed. Because of this eating habit, there are many patients with subclinical toxocariasis. Usually, these people are checked by clinicians because of eosinophilia or sometimes because of incidentally found small nodular lesions in the liver and/or lungs as seen on radiological imaging, such as sonography or CT.
References
1. Pulmonary Toxocariasis: Initial and Follow-Up CT Findings in 63 Patients : American Journal of Roentgenology 2015 204:6, 1203-1211
2. Transmission of Toxocara canis via Ingestion of Raw Cow Liver: A Cross-Sectional Study in Healthy Adults : Korean J Parasitol 2012 March Vol. 50, No. 1: 23-27
Keywords
Eosinophilic lung disease, Parasitic infection, Toxocariasis,

No. of Applicants : 74

▶ Correct Answer : 27/74,  36.5%
  • - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
  • - Jichi Medical University Hospital , Japan JUN KANZAWA
  • - , Japan KYOKO NAGAI
  • - Showa General Hospital , Japan MASAFUMI KAIUME
  • - Shiga University of Medical Science , Japan AKITOSHI INOUE
  • - , Italy PAOLO BALDASSARI
  • - Tiger Gate Hospital , Japan SHIN-ICHI CHO
  • - Other , Korea (South) SEONGSU KANG
  • - , Korea (South) JIN YOUNG LEE
  • - Oita University, Faculty of Medicine , Japan FUMITO OKADA
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
  • - Gifu University Hospital , Japan Yo Kaneko
  • - , Japan KENTARO KOTANI
  • - Ajou University Hospital , Korea (South) YOU NA KIM
  • - Osaka Metropolitan University Hospital , Japan SHU MATSUSHITA
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey MERIC TUZUN
  • - Osaka metropolitan university Hospital , Japan TATSUSHI OURA
  • - Chonnam National University Hwasun Hospital , Korea (South) JEONG YEOP LEE
  • - Other , Korea (South) KYU-CHONG LEE
  • - Kyoto University Hospital , Japan SATOSHI IKEDA
  • - Yonsei University,Severance Hospital , Korea (South) SEO BUM CHO
  • - Toranomon Hospital , Japan KAORU SUMIDA
  • - Nerimahikarigaoka hospital , Japan TAKANA HAYASHI
  • - , Japan YUKI HAYASHI
  • - Diagnose.me (BV) / Royal Perth Hospital , Australia YURANGA WEERAKKODY
  • - the first affiliatited hospital of nanjing medical univercity , China HAI XU
  • - Hanyang University Hospital , Korea (South) SEUNG JIN YOO
▶ Correct Answer as Differential Diagnosis : 8/74,  10.8%
  • - Kinki University Faculty of Medicine, , Japan MITSURU MATSUKI
  • - Osaka University , Japan AKINORI HATA
  • - Narayana Multispeciality Hospital Jaipur Rajasthan , India JAINENDRA JAIN
  • - Kyoto University Hospital , Japan YASUHISA KURATA
  • - Chungbuk National University Hospital , Korea (South) MIHYEON PARK
  • - Seoul National University Bundang Hospital , Korea (South) YOONAH DO
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - The University of Tokyo Hospital , Japan HIROSHI TAKUMIDA
▶ Semi-Correct Answer : 29/74,  39.2%
  • - Wakayama Red Cross Hospital , Japan TOMOAKI OTANI
  • - , Japan HIROAKI ARAKAWA
  • - ZIGONG TCM HOSPITAL OF CHINA , China CAO CUN YOU
  • - , United Kingdom SAMSON KADE
  • - McGill University Health Center , Canada ALEXANDRE SEMIONOV
  • - CHCB , France LE GUEN RAPHAEL
  • - NIMS, HYDERABAD , India BHASKAR K
  • - National Center of Neurology and Psychiatry , Japan MOTO NAKAYA
  • - Other , Korea (South) HWANGHEE JO
  • - Asan Medical Center , Korea (South) EUNJI CHOI
  • - Scans world , India PHILSON JOSEPH MUKKADA
  • - university of montreal , Canada Andrei Bogdan Gorgos I
  • - Shimada General Medical Center , Japan HAYATO NOZAWA
  • - , Korea (South) MINJI KIM
  • - Japanese Red Cross Medical Center , Japan YASUSHI AOYAGI
  • - Other , Korea (South) CHAEHUN LIM
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - Centre Hospitalier Regional de Lanaudiere , Canada MATTHIEU STORME
  • - Avrasya Hospital/ISTANBUL , Turkey MURAT ULUSOY
  • - Eskisehir Sehir Hastanesi , Turkey MURAT SAHIN
  • - Other , Korea (South) SEONG WON JANG
  • - Dokkyo Medical University , Japan HIROAKI ARAKAWA
  • - Holy Family Hospital , India RAJESH GOTHI
  • - TB centre kasaragod. , India rikhy krishnan
  • - , Japan KENSUKE DOMAE
  • - Paras hospital, Panchkula , India SHALEEN RANA
  • - , Japan YUMI MAEHARA
  • - The Catholic University of Korea Yoeuido St. Mary , Korea (South) CHAWOONG JEON
  • - Jiangsu province hospital , China WANGJIAN ZHA
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