TROPICAL EOSINOPHILIA

This is a disease that can be confused with tuberculosis, asthma, and cough related to roundworms. 

SYMPTOMS: Persistent or recurrent cough that gets aggravated at night, weakness, loss of weight and low fever raises the possible diagnosis of this disease. 

If you live in Bihar, Uttar Pradesh, West Bengal, Assam, Kerala or Tamil Nadu, doctors would first rule out this easily treatable condition before thinking of other diseases like tuberculosis or asthma. Tropical eosinophilia is more common in these states because of a higher incidence of filariasis in these regions. Tropical eosinophilia is considered a manifestation of a species of microfilaria.

Some children with this disease may also have enlargement of the glands in the neck and elsewhere. Others may cough up a little blood. The child may also have a wheeze. 

DIAGNOSIS: The diagnosis is made by doing a blood test which shows an absolute eosinophil count of more than 3000 eosinophils/mm3. For example, if the total white blood cell count is 20,000/mm3 and the eosinophils are 20%, the absolute eosinophil count shall come to 4000/mm3. In many cases, the child with this condition has a typical chest X-ray.

Children having roundworms may also have a similar sort of cough. But in all conditions that resemble tropical eosinophilia, the absolute eosinophil count is not so high. 

TREATMENT: The dramatic response to a commonly used drug for filaria (diethylcarbamazine) almost confirms the diagnosis.

11 February, 2013