[Diagnosis and management of parasitic hypereosinophilia]

Helminth infestation of the digestive tract or organ tissues is a common and curable cause of high eosinophil counts. Parasite infestation should be the number one suspect in patients with hypereosinophilia.

Clinical signs and epidemiology are suggestive. If the patient has travelled to the tropics, one should consider both exotic and cosmopolite parasites.

The causal agent can sometimes be identified by direct examination of tissue samples, depending on the localization. In practice however identification may be a difficult task when the level of infestation is low or the helminth is in a larval stage. The epidemiological situation, clinical features and results of serology tests must all be considered for diagnosis.

Clinical improvement after treatment can be a criteria for positive diagnosis. Normal eosinophil counts followed later by normal serology confirms the diagnosis.