Causes of Eosinophila
Related Subjects: Asthma
|Acute Severe Asthma
|Eosinophilic granulomatosis (Churg Strauss)
|Loffler's syndrome (Pulmonary Eosinophilia)
|Pulmonary Eosinophilia and CXR changes
|Drug Reaction Eosinophilia Systemic Symptoms
📌 Anybody with an eosinophil count > 0.4 × 10⁹/L should be investigated for both parasitic and non-parasitic causes.
📖 About
- Multiple causes can lead to elevated eosinophil counts, ranging from parasitic infections 🦠 to drug reactions 💊 and haematological disorders 🧬.
🧾 Causes
- 🪱 Parasitic infections:
- Ascaris lumbricoides
- Trichinella spiralis
- Fasciola hepatica
- Strongyloides
- Ankylostoma (hookworm)
- Toxocara
- Clonorchis sinensis
- Schistosomiasis
- Strongyloidiasis
- 🦠 Viral infections:
- 💊 Drugs (drug-induced eosinophilia):
- Sulfonamides
- Hydralazine
- Nitrofurantoin
- Aspirin
- Penicillin
- 🧬 Haematological conditions:
- Leukaemias and other myeloproliferative disorders.
- Hypereosinophilic syndrome (HES).
🩺 Clinical
- Often asymptomatic.
- When present: cough, wheeze, fever 🤒.
- 🌍 Travel history is essential for diagnosing parasitic causes.
🔬 Investigations
- Blood tests: Raised eosinophil count.
- CXR: May show transient pulmonary infiltrates (Loeffler’s syndrome).
- Stool microscopy: Ova, cysts, parasites.
- Terminal urine: Ova of Schistosoma haematobium.
- Duodenal aspirate: Strongyloides larvae, liver fluke ova.
- Day blood: Microfilariae of Brugia malayi, Loa loa.
- Night blood: Microfilariae of Wuchereria bancrofti.
- Skin snips: For Onchocerca volvulus.
- Serology: Schistosoma, filaria, hydatid, trichinosis, strongyloides, etc.
⚕️ Management
- 🦠 Eradicate infective causes (anthelmintics, antivirals as indicated).
- 💊 Stop causative drugs.
- 💉 Corticosteroids may be considered if cause remains idiopathic (hypereosinophilic syndrome).
- Monitor organ involvement (lungs, heart, liver, GI tract) in prolonged eosinophilia.
📚 References
