Abstract Body

Background and purpose: Eosinophilia is a common finding on asymptomatic patients in Primary health care. It usually relates to diseases that could have high-rate morbidity. Eosinophils have an important role on destroying foreign substances, like parasitic infections, and regulating inflammatory processes, such as allergic reactions. The most prevalent cause of eosinophilia on migrants or tropical travelers is parasitic diseases. Eosinophil count depends on host organism, parasite load and period of disease. High eosinophil count translates into tissue damage and amplification of inflammatory cascade, which in rare cases results into hypereosinophilic syndrome.

Methods: A 40-year-old Gambian man who lived in Girona (Spain) for the past 16-years presents with low eosinophilia on analysis since 2007. Reported a long history of intermittent asthma and is an untreated carrier of Hepatitis B. He visits origin country every 3-4 years. Last trip was 2 months ago. He presents with abdominal pain and distension. No fever, diarrhea, nausea or vomiting. We ordered blood analysis, serologic test and coproculture.

Results: Blood analysis revealed alanine aminotransferase (ALT) of 190U/L and HBV viral load of 877U/ml. Enzyme immunoassay revealed Strongyloides stercoralis. Coproculture revealed cysts of Entamoeba coli and trophozoites of Entamoeba histolytica dispar. Treatment was initiated with Metronidazole and Albendazole, resulting in significant improvement on abdominal pain and resolution of eosinophilia. Coproculture post-treatment was negative.

Conclusions: International travelling has increased transmission of infectious diseases. Primary health care should improve its knowledge around imported eosinophilia, alongside other imported diseases, in order to provide accurate diagnosis and treatment.