Flugmedizin · Tropenmedizin · Reisemedizin - FTR 2014; 21(2): 79-83
DOI: 10.1055/s-0034-1376163
Tropenmedizin
© Georg Thieme Verlag Stuttgart · New York

Eosinophilie bei Reiserückkehrern – Rationale Diagnostik

Eosinophilia in returning travelers – rational diagnostics
Thierry Rolling
1   Bernhard-Nocht-Ambulanz für Tropenmedizin, I. Medizinische Klinik und Poliklinik, Universitätsklinikum Hamburg-Eppendorf
,
Jakob P Cramer
1   Bernhard-Nocht-Ambulanz für Tropenmedizin, I. Medizinische Klinik und Poliklinik, Universitätsklinikum Hamburg-Eppendorf
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
22. April 2014 (online)

Bei 4–9 % der Reiserückkehrer aus tropischen und subtropischen Regionen lässt sich im Differenzialblutbild eine Eosinophilie (> 1500 Eosinophile/μl) nachweisen. Während in vielen Fällen eine Parasitose hierfür verantwortlich ist, ist der Nachweis einer solchen Infektion oft erschwert. In diesem Übersichtsartikel stellen wir die vorhandene Evidenz für eine effektive und effiziente Diagnostik vor.

If a full blood count is ordered in travelers returning from tropical and subtropical regions, eosinophilia (defined as > 1500 eosinophils/μl) can be detected in four to nine percent of cases. While a large part can be explained by parasitic diseases, their detection can be elaborate. In this review we present the existing evidence for an effective and efficient investigation of eosinophilia in returning travelers.

 
  • Literatur

  • 1 Rothenberg ME. Eosinophilia. N Engl J Med 1998; 338: 1592-1600
  • 2 Stone KD, Prussin C, Metcalfe DD. IgE, mast cells, basophils, and eosinophils. J Allergy Clin Immunol 2010; 125 (Suppl. 02) 73-80
  • 3 Carranza-Rodriguez C, Pardo-Lledias J, Muro-Alvarez A, Pérez-Arellano JL. Cryptic parasite infection in recent West African immigrants with relative eosinophilia. Clin Infect Dis 2008; 46: 48-50
  • 4 Sims H, Erber WN. Investigation of an incidental finding of eosinophilia. BMJ 2011; 342
  • 5 Brigden M, Graydon C. Eosinophilia detected by automated blood cell counting in ambulatory North American outpatients. Incidence and clinical significance. Arch Pathol Lab Med 1997; 121: 963-967
  • 6 Whitty CJ, Carroll B, Armstrong M et al. Utility of history, examination and laboratory tests in screening those returning to Europe from the tropics for parasitic infection. Trop Med Int Health 2000; 5: 818-823
  • 7 Lombardi C, Passalacqua G. Eosinophilia and diseases: clinical revision of 1862 cases. Arch Intern Med 2003; 163: 1371-1373
  • 8 Whetham J, Day JN, Armstrong M et al. Investigation of tropical eosinophilia; assessing a strategy based on geographical area. J Infect 2003; 46: 180-185
  • 9 Meltzer E, Percik R, Shatzkes J et al. Eosinophilia among returning travelers: a practical approach. Am J Trop Med Hyg 2008; 78: 702-709
  • 10 Gray TJ, Kwan YL, Phan T et al. Dientamoeba fragilis: a family cluster of disease associated with marked peripheral eosinophilia. Clin Infect Dis 2013; 57: 845-848
  • 11 Esposito DH, Freedman DO, Neumayr A, Parola P. Ongoing outbreak of an acute muscular Sarcocystis-like illness among travellers returning from Tioman Island, Malaysia, 2011–2012. Euro Surveill 2012; 17
  • 12 Checkley AM, Chiodini PL, Dockrell DH et al. Eosinophilia in returning travellers and migrants from the tropics: UK recommendations for investigation and initial management. J Infect 2010; 60: 1-20
  • 13 Ehrhardt S, Burchard GD. Eosinophilia in returning travelers and migrants. Dtsch Arztebl Int 2008; 105: 801-807
  • 14 Meltzer E, Schwartz E. Approach to Travel-Related Eosinophilia. In: Schwartz E, ed. Tropical Diseases in Travelers. Chichester: Wiley-Blackwell; 2009: 389-402
  • 15 Whetham J, Day JN, Armstrong M et al. Investigation of tropical eosinophilia; assessing a strategy based on geographical area. J Infect 2003; 46: 180-185
  • 16 Tukahebwa EM, Magnussen P, Madsen H et al. A very high infection intensity of Schistosoma mansoni in a Ugandan Lake Victoria Fishing Community is required for association with highly prevalent organ related morbidity. PLoS Negl Trop Dis 2013; 7
  • 17 Abdel-Salam E, Ehsan A. Cystoscopic picture of Schistosoma haematobium in Egyptian children correlated to intensity of infection and morbidity. Am J Trop Med Hyg 1978; 27: 774-778
  • 18 Greaves D, Coggle S, Pollard C et al. Strongyloides stercoralis infection. BMJ 2013; 347
  • 19 Prendki V, Fenaux P, Durand R et al. Strongyloidiasis in man 75 years after initial exposure. Emerg Infect Dis 2011; 17: 931-932
  • 20 Kobayashi S, Inokuma S, Setoguchi K et al. Incidence of peripheral blood eosinophilia and the threshold eosinophile count for indicating hypereosinophilia-associated diseases. Allergy 2002; 57: 950-956
  • 21 Ross AG, Vickers D, Olds GR et al. Katayama syndrome. Lancet Infect Dis 2007; 7: 218-224
  • 22 Wichmann D, Poppert S, Von Thien H et al. Prospective European-wide multicentre study on a blood based real-time PCR for the diagnosis of acute schistosomiasis. BMC Infect Dis 2013; 13: 55-55