[Severe eosinophilia in a patient with clostridium colitis and gastric cancer].
A case of a 77-year-old male repeatedly hospitalized with the diagnosis of Clostridium difficile colitis associated with eosinophilia is presented. The percentage and number of eosinophils achieved maximal values (54 %, 5.4 times 1.000.000.000/l) during repeated treatment with metronidazole. Eosinophilia was accompanied by significant elevation of serum IgE and presence of Charcot-Leyden crystals in stool. Helminth infections and hemoblastosis were ruled out as the cause and a working diagnosis of eosinophilic gastroenterocolitis induced by antibiotics was established. The working diagnosis was supported by a decrease in eosinophils observed after a switch from metronidazole to vancomycin. After one month, the patient was hospitalized with gastrectasia, for which gastric biopsy was performed with a finding of infiltrating carcinoma. A differential diagnostic approach to patients with eosinophilia is discussed and the need for ruling out relatively rare causes such as tumors is stressed.
Charles University Prague, 1st Medical Faculty, Department of Infectious and Tropical Diseases, Hospital na Bulovce Prague, Czech Republic. michal.holub@lf1.cuni.cz
Michal
M
Holub
Simona
S
Arientová
Marcela
M
Kořínková
Marie
M
Reisingerová
Vilma
V
Marešová
D000368:Aged; D016360:Clostridioides difficile; D003937:Diagnosis, Differential; D004761:Enterocolitis, Pseudomembranous / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D004802:Eosinophilia / Q000150:complications*; D006801:Humans; D008297:Male; D013274:Stomach Neoplasms / Q000150:complications*