Chen Irene, Lott Limbach Abberly
Department of Pathology and Laboratory Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Pathology, Ohio State University Wexner Medical Center, E422 Doan Hall, 410 W 10th Ave, Columbus, OH, 43210, USA.
Head Neck Pathol. 2025 Mar 24;19(1):37. doi: 10.1007/s12105-025-01759-1.
Eosinophilia, defined as an elevated eosinophil count either in blood or tissue, has diverse implications for diagnosing and managing various diseases. Elevated eosinophil levels are often associated with conditions such as allergic reactions, autoimmune disorders, and specific infections. In the realm of head and neck pathology, eosinophilia can offer valuable insights into underlying infectious processes, which are often challenging to diagnose due to their overlap with other inflammatory and allergic conditions. This review describes the roles of blood and tissue eosinophilia in several infectious processes affecting the head and neck region. We focus on nine key conditions: allergic fungal rhinosinusitis, mycetoma, invasive fungal rhinosinusitis, rhinosporidiosis, baylisascariasis, toxocariasis, onchocerciasis, loiasis, and histoplasmosis. Allergic fungal rhinosinusitis, for example, is a hypersensitivity reaction to fungal antigens and is frequently associated with significant eosinophilic inflammation. Conversely, mycetoma, invasive fungal rhinosinusitis, and rhinosporidiosis may include eosinophils as part of a mixed inflammatory infiltrate. Histoplasmosis may also induce systemic eosinophilia as an atypical immune response to fungal infection. Additionally, baylisascariasis, toxocariasis, onchocerciasis, and loiasis are parasitic infections that often lead to systemic eosinophilia. By exploring these conditions, this review elucidates how identification of eosinophilia contributes to the diagnostic process. Understanding the association between eosinophilia and these infectious processes involving the head and neck is crucial for enhancing diagnostic accuracy, differentiating between similarly presenting conditions, and guiding effective treatment strategies.
嗜酸性粒细胞增多症定义为血液或组织中嗜酸性粒细胞计数升高，对各种疾病的诊断和管理具有多种影响。嗜酸性粒细胞水平升高通常与过敏反应、自身免疫性疾病和特定感染等情况相关。在头颈部病理学领域，嗜酸性粒细胞增多症可为潜在的感染过程提供有价值的见解，由于这些感染过程与其他炎症和过敏情况重叠，其诊断往往具有挑战性。本综述描述了血液和组织嗜酸性粒细胞增多症在影响头颈部区域的几种感染过程中的作用。我们重点关注九种关键病症：变应性真菌性鼻-鼻窦炎、足菌肿、侵袭性真菌性鼻-鼻窦炎、鼻孢子虫病、贝利斯蛔虫病、弓蛔虫病、盘尾丝虫病、罗阿丝虫病和组织胞浆菌病。例如，变应性真菌性鼻-鼻窦炎是对真菌抗原的超敏反应，常伴有显著的嗜酸性粒细胞炎症。相反，足菌肿、侵袭性真菌性鼻-鼻窦炎和鼻孢子虫病可能包括嗜酸性粒细胞作为混合性炎症浸润的一部分。组织胞浆菌病也可能作为对真菌感染的非典型免疫反应诱导全身性嗜酸性粒细胞增多。此外，贝利斯蛔虫病、弓蛔虫病、盘尾丝虫病和罗阿丝虫病是寄生虫感染，常导致全身性嗜酸性粒细胞增多。通过探讨这些病症，本综述阐明了嗜酸性粒细胞增多症的识别如何有助于诊断过程。了解嗜酸性粒细胞增多症与这些涉及头颈部的感染过程之间的关联对于提高诊断准确性、区分表现相似的病症以及指导有效的治疗策略至关重要。
