[Clinical approach to imported eosinophilia]

Area of Science:

• * Infectious Diseases
• * Clinical Parasitology
• * Travel Medicine

Background:

• * Eosinophilia is frequently observed in international travelers and immigrants.
• * Helminthic infections are the primary cause, but eosinophilia has low positive predictive value for helminthosis in this population.
• * Diagnosing helminthic infections can be challenging due to the low sensitivity and specificity of diagnostic tests.

Purpose of the Study:

• * To outline a structured diagnostic approach for eosinophilia in travelers.
• * To guide the assessment and management of potential helminthic infections.
• * To emphasize the importance of screening for Strongyloides stercoralis in specific patient groups.

Main Methods:

• * Comprehensive anamnesis and physical examination.
• * Basic laboratory tests, including stool parasitological examination.
• * Strongyloides stercoralis serology, with additional tests based on clinical suspicion.

Main Results:

• * A structured approach considering geographical area, exposures, and symptoms is recommended.
• * Empiric treatment with albendazole, ivermectin, and praziquantel is an option for persistent, unidentified eosinophilia.
• * Pre-treatment screening for Strongyloides stercoralis is crucial for patients undergoing immunosuppressive therapy.

Conclusions:

• * Eosinophilia in travelers requires a systematic diagnostic strategy.
• * Prompt diagnosis and treatment are vital, especially for Strongyloides stercoralis to prevent hyperinfection.
• * Empiric treatment can be considered when definitive diagnosis is not feasible.