OBJECTIVE: To determine the etiology of eosinophilia in immigrant patients in Southern Spain. METHODS: Prospective study of immigrant patients with eosinophilia (> 500 Eo/μL) attended in a reference Tropical Medicine Unit and evaluated through the implementation of a specific protocol structured in different levels meant to be accomplished depending on the findings of each previous level. RESULTS: Out of the 549 patients included in the study (89.6% from sub-Saharan countries), a diagnosis of helminthiasis was reached in 417 (75.9%), mainly by Strongyloides stercoralis (n = 190), Schistosoma (n = 33) and Hookworms (n = 126). 30 patients (5.5%) had a non-parasitic disorder (asthma, allergic rhinoconjunctivitis, skin conditions and drug-related eosinophilia). Multiple helminthic infections were very common: in 107 patients (19.5%) 2 helminth species were identified, three in 21 patients (3.8%), and four or more in 6 patients (1.1%). Eosinophilia was resolved in 31 of the 33 patients (93.9%) who received empirical treatment with ivermectin, albendazole and praziquantel as an etiological diagnosis was not reached after applying the whole protocol. CONCLUSIONS: Diagnosis of helminthic infections in immigrant patients with eosinophilia can be improved by using tailored protocols based on geographical exposure. The implementation of these protocols may also save costs by systematizing diagnostic explorations. Empirical treatment with ivermectin, albendazol and praziquantel in sub-Saharan population when an etiologic diagnosis of eosinophilia has not been attained is an effective measure.
OBJECTIVE: To determine the etiology of eosinophilia in immigrant patients in Southern Spain. METHODS: Prospective study of immigrant patients with eosinophilia (> 500 Eo/μL) attended in a reference Tropical Medicine Unit and evaluated through the implementation of a specific protocol structured in different levels meant to be accomplished depending on the findings of each previous level. RESULTS: Out of the 549 patients included in the study (89.6% from sub-Saharan countries), a diagnosis of helminthiasis was reached in 417 (75.9%), mainly by Strongyloides stercoralis (n = 190), Schistosoma (n = 33) and Hookworms (n = 126). 30 patients (5.5%) had a non-parasitic disorder (asthma, allergic rhinoconjunctivitis, skin conditions and drug-related eosinophilia). Multiple helminthic infections were very common: in 107 patients (19.5%) 2 helminth species were identified, three in 21 patients (3.8%), and four or more in 6 patients (1.1%). Eosinophilia was resolved in 31 of the 33 patients (93.9%) who received empirical treatment with ivermectin, albendazole and praziquantel as an etiological diagnosis was not reached after applying the whole protocol. CONCLUSIONS: Diagnosis of helminthic infections in immigrant patients with eosinophilia can be improved by using tailored protocols based on geographical exposure. The implementation of these protocols may also save costs by systematizing diagnostic explorations. Empirical treatment with ivermectin, albendazol and praziquantel in sub-Saharan population when an etiologic diagnosis of eosinophilia has not been attained is an effective measure.
Authors: Joaquín Salas-Coronas; María Teresa Cabezas-Fernández; Ana Belén Lozano-Serrano; Manuel Jesús Soriano-Pérez; José Vázquez-Villegas; José Ángel Cuenca-Gómez Journal: Am J Trop Med Hyg Date: 2018-01 Impact factor: 2.345
Authors: Alfonso J Rodríguez-Morales; María Camila Yepes-Echeverri; Wilmer F Acevedo-Mendoza; Hamilton A Marín-Rincón; Carlos Culquichicón; Esteban Parra-Valencia; Jaime A Cardona-Ospina; Ana Flisser Journal: Travel Med Infect Dis Date: 2017-12-27 Impact factor: 6.211
Authors: Pedro Puerta-Alcalde; Joan Gomez-Junyent; Ana Requena-Mendez; Maria Jesús Pinazo; Miriam José Álvarez-Martínez; Natalia Rodríguez; Joaquim Gascon; Jose Muñoz Journal: PLoS Negl Trop Dis Date: 2018-01-31