Distinguishment of parasite-infected children from pediatric inpatients with both eosinophilia and effusion

Abstract

Patients with both serous effusion and eosinophilia are rarely reported and geographically distributed; their early diagnosis is difficult. According to the ultimate diagnosis, patients (≤14 years) in West China Second hospital with serous effusion and eosinophilia were divided into two groups including a parasitic group and a non-parasitic group. Clinical data were collected and analyzed between the two groups. Subsequently, significant measurement indicators were evaluated by receiver operating characteristic (ROC) curve to explore the optimal cut-off points for the most appropriate sensitivity and specificity. A total of 884 patients were diagnosed with serous effusion and 61 of them displayed co-morbidity with eosinophilia during enrolled time. Among 61 patients, 34 patients had parasitic infection and 27 had non-parasitic diseases. There were statistical difference in effusion position, the levels of white blood cell count (WBC), eosinophil (EOS), EOS%, C-reactive protein (CRP) between parasitic group and non-parasitic group. ROC curve demonstrated that the areas under the curve of EOS count and EOS% were >80%, and the corresponding optimal cut-off values were 1.71 × 10 9 /L and 25.6% for distinguishing between parasitic and non-parasitic infections in our patients. This study provided a quantified index for potentially quick and convenient indicators of pediatric patients presenting with both eosinophilia and effusion. Eosinophils were helpful to improve the initial diagnosis with awareness of parasitic diseases. For the cases with EOS > 1.71 × 10 9 /L or EOS% > 25.6%, parasitic infection should be considered and serological tests are recommended in our region.

Eosinophilic pleural effusion in an eleven-year-old boy

“…3 Reports of paediatric eosinophilic PE are infrequently found in the literature. Reports are published regarding parasite infected 4 or idiopathic 5 cases. Association with subcutaneous cysticercosis, 6 giardiasis, 7 and idiopathic hypereosinophilic syndromes 8 are reported.…”