EOSINOPHILIA IN THE RETURNING TRAVELER
Identifieur interne : 00B270 ( Main/Exploration ); précédent : 00B269; suivant : 00B271EOSINOPHILIA IN THE RETURNING TRAVELER
Auteurs : Thomas A. Moore ; Thomas B. NutmanSource :
- Infectious Disease Clinics of North America [ 0891-5520 ] ; 1998.
Abstract
Elevations in the levels of peripheral blood and tissue eosinophils can occur in a wide variety of disease processes that include infectious, allergic, neoplastic and other, often idiopathic diseases75,76,77 (Table 1). Worldwide, parasites are the major group of infectious agents responsible for eosinophilia. Eosinophilia is characteristically associated with the multicellular helminthic parasites that include the nematodes (roundworms), cestodes (flatworms), and trematodes (flukes). Unicellular protozoan parasites rarely, if ever, elicit eosinophilia. Thus, the finding of peripheral eosinophilia in the returning traveler strongly suggests infection with a helminth;30 however, the absence of eosinophilia does exclude the presence of a parasite19; nor is eosinophilia the sine qua non of parasitic disease. The returned traveler with eosinophilia has features of the eosinophilia that are unique compared with other patients undergoing evaluation for eosinophilia. First, exposure in travelers can usually be defined temporallyas the time of initial exposure is knownin contrast to those who have had lifelong or long-term residence in parasite-endemic regions of the world in which there is neither an identifiable nor discrete period of exposure. Second, travelers may have had exposure to infectious agents or to medications that are associated with eosinophilia. Finally, travelers and long-term but temporary visitors to helminth-endemic regions of the world (i.e., individuals not previously exposed to helminth infections) can have heightened immune responses to the parasite, most notably a more pronounced eosinophilia, that differs from those of individuals born and bred in helminth-endemic regions.35,56,59,75 While often directed at helminth infections in their early stages of clinical evolution, the evaluation of eosinophilia in the returning traveler must consider the many etiologies of eosinophilia including those not causally related to recent travel. This article thus reviews the relevant biology of eosinophils and examines the various causes of eosinophilia encountered after travel.
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DOI: 10.1016/S0891-5520(05)70016-7
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Moore</name></author><author><name sortKey="Nutman, Thomas B" sort="Nutman, Thomas B" uniqKey="Nutman T" first="Thomas B." last="Nutman">Thomas B. Nutman</name></author></analytic><monogr></monogr><series><title level="j">Infectious Disease Clinics of North America</title><title level="j" type="abbrev">IDC</title><idno type="ISSN">0891-5520</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1998">1998</date><biblScope unit="volume">12</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="503">503</biblScope><biblScope unit="page" to="521">521</biblScope></imprint><idno type="ISSN">0891-5520</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0891-5520</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Elevations in the levels of peripheral blood and tissue eosinophils can occur in a wide variety of disease processes that include infectious, allergic, neoplastic and other, often idiopathic diseases75,76,77 (Table 1). Worldwide, parasites are the major group of infectious agents responsible for eosinophilia. Eosinophilia is characteristically associated with the multicellular helminthic parasites that include the nematodes (roundworms), cestodes (flatworms), and trematodes (flukes). Unicellular protozoan parasites rarely, if ever, elicit eosinophilia. Thus, the finding of peripheral eosinophilia in the returning traveler strongly suggests infection with a helminth;30 however, the absence of eosinophilia does exclude the presence of a parasite19; nor is eosinophilia the sine qua non of parasitic disease. The returned traveler with eosinophilia has features of the eosinophilia that are unique compared with other patients undergoing evaluation for eosinophilia. First, exposure in travelers can usually be defined temporallyas the time of initial exposure is knownin contrast to those who have had lifelong or long-term residence in parasite-endemic regions of the world in which there is neither an identifiable nor discrete period of exposure. Second, travelers may have had exposure to infectious agents or to medications that are associated with eosinophilia. Finally, travelers and long-term but temporary visitors to helminth-endemic regions of the world (i.e., individuals not previously exposed to helminth infections) can have heightened immune responses to the parasite, most notably a more pronounced eosinophilia, that differs from those of individuals born and bred in helminth-endemic regions.35,56,59,75 While often directed at helminth infections in their early stages of clinical evolution, the evaluation of eosinophilia in the returning traveler must consider the many etiologies of eosinophilia including those not causally related to recent travel. This article thus reviews the relevant biology of eosinophils and examines the various causes of eosinophilia encountered after travel.</div></front></TEI><affiliations><list></list><tree><noCountry><name sortKey="Moore, Thomas A" sort="Moore, Thomas A" uniqKey="Moore T" first="Thomas A." last="Moore">Thomas A. Moore</name><name sortKey="Nutman, Thomas B" sort="Nutman, Thomas B" uniqKey="Nutman T" first="Thomas B." last="Nutman">Thomas B. Nutman</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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