How Common is Eosinophilia in Tuberculosis? Case Report

Though peripheral blood eosinophilia is common due to allergic diseases, drugs, parasitic infections, and malignancies, it is rarely reported due to tuberculosis (TB). The association between eosinophilia and TB is not well known. We have a case of the 9-year-old female present with abdominal pain in the right upper quadrant which is non-radiating associated with decreased appetite, weight loss, malaise and low-grade fever and vomiting of ingested of two weeks. On examination, she had severe wasting and hepatomegaly. On investigations, she had leukocytosis with 50% of eosinophilia, high ESR, multiple liver cysts (abdominal ultrasound and CT) and biopsy suggestive of TB. Finally, the patient started on anti-TB and her response was followed by clinical and laboratory parameters. After three weeks of treatment with anti-TB, she starts to gain weight, improve abdominal pain, appetite loss, and the investigation also normalized (leukocyte and the eosinophil become normalized, ESR corrected). The patient was to follow up for two years in the clinic and finally discharged. The coexistence of eosinophilia and TB in our patient is suggested because of the biopsy results in conjunction with the improvement of peripheral blood eosinophilia with anti-TB treatment. This example hopefully will encourage future investigations and researchers to look at the prevalence and a clear association of TB and peripheral eosinophilia.