Eosinophilia among returning travelers: a practical approach.
Eosinophilia is not uncommon among returning travelers; however, the optimal diagnostic and therapeutic approach in travelers, as opposed to immigrants and refugees, is not clearly established. This was a retrospective case series. All returning travelers from developing countries presenting at the post-travel clinic with eosinophilia (>or= 500 cells/mcl) during 1994-2006 were evaluated. Data were compared with other referrals to the post-travel clinic and with a random sample of a pre-travel clinic. Of the 955 returning travelers evaluated during the study period, 82 (8.6%) had eosinophilia, and 44 (4.4%) were diagnosed with schistosomiasis. Another 38 (4.2%) cases presented with non-schistosomal eosinophilia (NSE), among whom a definite parasitologic diagnosis was achieved in only 23.7%. However, an empiric course of albendazole led to a clinical improvement in 90% of NSE cases. Helminthic disease probably accounts for the majority of cases of post-travel eosinophilia. Empiric albendazole therapy should be offered to undiagnosed NSE patients.
Meltzer
Eyal
E
Department of Medicine C, The Chaim Sheba Medical Center, Tel Hashomer, Israel. emeltzer@post.tau.ac.il
Percik
Ruth
R
Shatzkes
Joshua
J
Shatzkes
Joshuah
J
Sidi
Yehezkel
Y
Schwartz
Eli
E
D015766:Albendazole / Q000627:therapeutic use*; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D003906:Developing Countries; D004802:Eosinophilia / Q000209:etiology*; D004804:Eosinophils; D005260:Female; D006801:Humans; D007557:Israel; D007958:Leukocyte Count; D010063:Ovum; D010269:Paraquat / Q000627:therapeutic use*; D012189:Retrospective Studies; D012547:Schistosoma / Q000302:isolation & purification; D012552:Schistosomiasis / Q000175:diagnosis* / Q000188:drug therapy; D014195:Travel
D000871:Anthelmintics; D015766:Albendazole; D010269:Paraquat