Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
Hypereosinophilia in a Three-Year-Old Child: Case Report



Alinia G1 ; Alimadadi H2 ; Afshoon M1 ; Borhani K3 ; Yaghmaie B1 ; Khodabandeh M3
Authors
Show Affiliations
Authors Affiliations
  1. 1. Pediatric's Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Pediatric Hepatic and Gastrointestinal Diseases Research Center, Pediatric's Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Pediatric's Infectious Diseases, Pediatric's Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran

Source: Tehran University Medical Journal Published:2020

Abstract

Background: Hypereosinophilic syndrome is commonly found in various diseases such as allergic diseases, parasitic diseases, malignancies, etc. Fasciolosis may present with different clinical features, and it can make a difficult diagnosis of the disease. Laboratory manifestations of fascioliasis are eosinophilia. The purpose of this report was to introduce a child with hypereosinophilia that her diagnosis was fascioliasis. Case Presentation: The patient was a 3-year-old girl who was referred for prolonged fever (more than two weeks) and abdominal pain from another medical center, and she was hospitalized. In abdominal and pelvic ultrasound, splenomegaly was seen and in laboratory tests, she had hypereosinophilia. In the flow cytometry of bone marrow aspiration, the only finding was increased eosinophil level. Abdominal and thoracic a computerized tomography (CT) scans showed an increased size of para-aortic lymph nodes. On her examination, lymphadenopathy was present in the inguinal region. Therefore, a biopsy of an inguinal lymph node was performed to rule out lymphoma. Lymph node biopsy was negative for lymphoma. Fasciola serology was performed for the patient, and the stool exam was collected three times (for one day in between) to rule out parasitic disease, including Fasciola, etc. Due to weakly positive serology Fasciola hepatica, triclabendazole was started for the patient (it was given in two doses, 12 hours apart), despite the absence of Fasciola parasitic eggs in her stool. During hospitalization, the patient's fever was stopped and by starting the use of mentioned drug, eosinophilia was reduced. The patient received a complete improvement in the follow-up. Conclusion: In patients with hypereosinophilia, parasitic diseases such as fascioliasis should be considered even if the fecal specimen is negative for Fasciola eggs. © 2020 Tehran University of Medical Sciences. All rights reserved.