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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Child With High Eosinophils. Losing Weight, Cough, Leg Pain, Fatigue And Mouth Sores. Cause?

My son has high eosinophil levels - 1.5 has been tested for asthma and parasitic infection both negative, but losing weight, suffering fatigue, sores around the mouth, night sweats and aches and pains in legs with a persistent cough for nearly 5 months. He is 9 years old, weights 4st 7 lbs and is 4ft 8ins in height. What is causing his symptoms?
Thu, 4 Apr 2013
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Pediatrician 's  Response
Hi,

Thank you for your query on Healthcare Magic.

High eosinophil count, persistent cough of 5 months duaration, night sweats, fatiugue all these symptoms can be correlated with some allergic or hypersensitivity syndromes.

I would like to rule out the following problems :

1. Tropical pulmonary eosinophilia which is seen in coastal areas associated with parasite microfilaria.

2. Worm infestations

3. Loefflers syndrome which again associated with worm infestation like ascariasis.

Further evaluation is reqired with complete blood picture, serum IgE levels, Chest X-ray, and allergic testing.

If it is due to tropical pulmonary eosinophilia, the symptoms will respond to 10 days course of diethyl carbamazine as the positive response is both the diagnostic and therapeutic. And symptoms will improve with the addition of montelukast.

Intestinal worm infestation can be associated with eosinophilia and can be treated with antihelminthic drugs like albendazole.

Therefore I advise you to consult the Pediatrician for further evaluation and for the treatment.

Hope I have answered your query.

Regards.
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2 Doctors agree with this answer

General & Family Physician Dr. Ramesh M.Vachharajani's  Response
Hi,
Welcome to HCM,
Eosinophilia is a chronic condition having various causes.
Empirically go for one course of warm infestation even it is negative.
Go for one course of medicine Di ethyl carbamazine after consulting your doctor.
Avoid allergen if known.
Ok and bye.
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Child With High Eosinophils. Losing Weight, Cough, Leg Pain, Fatigue And Mouth Sores. Cause?

Hi, Thank you for your query on Healthcare Magic. High eosinophil count, persistent cough of 5 months duaration, night sweats, fatiugue all these symptoms can be correlated with some allergic or hypersensitivity syndromes. I would like to rule out the following problems : 1. Tropical pulmonary eosinophilia which is seen in coastal areas associated with parasite microfilaria. 2. Worm infestations 3. Loefflers syndrome which again associated with worm infestation like ascariasis. Further evaluation is reqired with complete blood picture, serum IgE levels, Chest X-ray, and allergic testing. If it is due to tropical pulmonary eosinophilia, the symptoms will respond to 10 days course of diethyl carbamazine as the positive response is both the diagnostic and therapeutic. And symptoms will improve with the addition of montelukast. Intestinal worm infestation can be associated with eosinophilia and can be treated with antihelminthic drugs like albendazole. Therefore I advise you to consult the Pediatrician for further evaluation and for the treatment. Hope I have answered your query. Regards.