title: [Clinical approach to imported eosinophilia].
abstract: Eosinophilia is a common finding in international travelers and immigrants, being an helmintic infection its main etiology. The positive predictive value of eosinophilia for an helmintosis is low in travellers. Eosinophilia may be an incidental finding, or symptomatic, and it represents a clinical challenge due to the low sensitivity and specificity of direct and indirect parasitological diagnostic tests, respectively. It requires a structured approach based on geographical areas, environmental exposures and behavioral risks, and associated symptoms. The initial assessment should include a comprehensive and tailored anamnesis and physical examination, basic laboratory tests, a complete parasitological examination of stool samples and a Strongyloides stercoralis serology, supplemented with other explorations guided by epidemiological and clinical suspicion. Empiric treatment with albendazole and/or ivermectin (plus praziquantel if risk of schistosomiasis) is an option for unidentified persistent eosinophilia after study, and in persons in whom a proper assessment or follow-up can not be assured. In patients at risk for estrongiloidosis who are candidates for immunosuppressive therapies, it is indicated a prior screening and treatment to prevent a future hyperinfestation syndrome.
authors.affiliation: Unidad de Gestión Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío y Virgen Macarena, Sevilla, España. Electronic address: eliascanas@gmail.com.
authors.forename: Elías
authors.initials: E
authors.lastname: Cañas García-Otero
authors.affiliation: Unidad de Gestión Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío y Virgen Macarena, Sevilla, España.
authors.forename: Julia
authors.initials: J
authors.lastname: Praena-Segovia
authors.affiliation: Unidad de Gestión Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío y Virgen Macarena, Sevilla, España.
authors.forename: Maite
authors.initials: M
authors.lastname: Ruiz-Pérez de Pipaón
authors.affiliation: Unidad de Gestión Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío y Virgen Macarena, Sevilla, España.
authors.forename: Xerach
authors.initials: X
authors.lastname: Bosh-Guerra
authors.affiliation: Unidad de Gestión Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío y Virgen Macarena, Sevilla, España.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Sánchez-Agüera
authors.affiliation: Unidad de Gestión Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío y Virgen Macarena, Sevilla, España.
authors.forename: Daniel
authors.initials: D
authors.lastname: Álvarez-Martínez
authors.affiliation: Unidad de Gestión Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío y Virgen Macarena, Sevilla, España.
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Cisneros-Herreros
mesh_terms: D015766:Albendazole / Q000627:therapeutic use; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D000076263:Communicable Diseases, Imported / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D004802:Eosinophilia / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007559:Ivermectin / Q000627:therapeutic use; D017171:Strongyloides stercoralis; D013322:Strongyloidiasis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D000871:Anthelmintics; D007559:Ivermectin; D015766:Albendazole
keywords: Eosinofilia; Eosinophilia; Immigrants; Inmigrantes; International travelers; Viajeros internacionales