Parasitic hypereosinophilia in childhood: a diagnostic challenge

Roberto Antonucci, Nadia Vacca, Giulia Boz, Cristian Locci, Rosanna Mannazzu, Claudio Cherchi, Giacomo Lai, Claudio Fozza
  • Roberto Antonucci
    Pediatric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy, Italy | rantonucci@uniss.it
  • Nadia Vacca
    Pediatric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy, Italy
  • Giulia Boz
    Pediatric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy, Italy
  • Cristian Locci
    Pediatric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy, Italy
  • Rosanna Mannazzu
    Pediatric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy, Italy
  • Claudio Cherchi
    Respiratory Unit, Academic Department of Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy, Italy
  • Giacomo Lai
    Pediatric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy, Italy
  • Claudio Fozza
    Hematology, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy, Italy

Abstract

Severe hypereosinophilia (HE) in children is rare, and its etiological diagnosis is challenging. We describe a case of a 30-month-old boy, living in a rural area, who was admitted to our Clinic with a 7-day history of fever and severe hypereosinophilia. A comprehensive diagnostic work-up could not identify the cause of this condition. On day 6, the rapidly increasing eosinophil count (maximum value of 56,000/mm3), the risk of developing hypereosinophilic syndrome, and the patient’s history prompted us to undertake an empiric treatment with albendazole.The eosinophil count progressively decreased following treatment. On day 13, clinical condition and hematological data were satisfactory, therefore the treatment was discontinued and the patient was discharged. Three months later, anti-nematode IgG antibodies were detected in patient serum, thus establishing the etiological diagnosis. In conclusion, an empiric anthelmintic treatment seems to be justified when parasitic hypereosinophilia is strongly suspected, and other causes have been excluded.

Keywords

hypereosinofilia, hypereosinophilic syndrome, children, diagnosis, albendazole, parasitosis, elminthiasis, nematode.

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Submitted: 2018-02-21 18:44:11
Published: 2018-05-01 00:00:00
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