Rasul Taha F, Bergholz Daniel R, Faiz Arfa
Medicine, University of Miami Miller School of Medicine, Miami, USA.
Allergy and Immunology, Sutter Medical Center, Sacramento, USA.
Cureus. 2021 Dec 3;13(12):e20140. doi: 10.7759/cureus.20140. eCollection 2021 Dec.
Peripheral eosinophilia is a potentially concerning finding that can occur due to a multitude of causes. One such cause is latent helminth infections such as Strongyloides stercoralis. These parasites have broad distributions throughout the developing world, particularly South and Southeast Asia and it is estimated that roughly 200 million people have latent infections. We present the case of a 74-year-old patient from India who had asymptomatic eosinophilia since before 2006. He previously underwent an extensive workup which included testing for neoplasms, gene mutations, and lymphoproliferative disorders. After carefully examining the patient's travel history and demographic information, a parasite panel was administered which was positive for Strongyloides, thereby establishing a cause for his condition after years of expensive testing. Latent Strongyloides infections can lead to fatal dissemination if the host becomes immunocompromised. It is therefore essential to keep a detailed history of patient travel, occupation, and functional status when assessing peripheral eosinophilia so that obvious causes are not overlooked.
外周嗜酸性粒细胞增多是一个潜在的令人担忧的发现，可能由多种原因引起。其中一个原因是潜在的蠕虫感染，如粪类圆线虫。这些寄生虫在整个发展中世界广泛分布，特别是南亚和东南亚，据估计约有2亿人有潜在感染。我们报告一例来自印度的74岁患者，自2006年以前就有无症状嗜酸性粒细胞增多。他之前接受了广泛的检查，包括肿瘤、基因突变和淋巴增殖性疾病检测。在仔细检查患者的旅行史和人口统计学信息后，进行了寄生虫检测，结果粪类圆线虫呈阳性，从而在多年昂贵的检测后确定了其病情的病因。如果宿主免疫功能低下，潜在的粪类圆线虫感染可导致致命的播散。因此，在评估外周嗜酸性粒细胞增多时，详细记录患者的旅行史、职业和功能状态至关重要，以免忽视明显的病因。
