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MCQs in Tropical Medicine

Rob Skelly DTM+H FRCP

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Answer 1

The following are recognised causes of eosinophilia

False a. malaria
False b. visceral leishmaniasis
True
c. Churg-Strauss syndrome
True d. drug hypersensitivity
True e. visceral larva migrans (toxocariasis)

The upper limit of normal for eosinophils is usually taken to be 0.4x10^9/l. The causes of eosinophilia may conveniently be divided into two groups: parasitic and non-parasitic. In general protazoal infections do not produce eosinophilia. Helminths do cause eosinophilia and the degree of eosinophilia is related to the extent of tissue invasion by the helminth. Filarial worms often cause a high eosinophilia whereas the intestinal nematodes tend to cause only a modest increase in the eosinophil count.

Table1.1

Important parasitic causes of eosinophilia

Filarial worms
Tapeworms
Strongyloidiasis
Hydatid disease
Hookworm
Fascioliasis
Toxocariasis (visceral larva migrans)
Schistosomiasis
Trichinella spiralis
Intestinal nematodes
Tropical pulmonary eosinophilia (usually results from hypersensitivity to microfilariae)

Table 1.2

Non-parasitic causes of
eosinophilia
Allergic disorders

Allergic disorders
Asthma
Eczema
Hayfever
Drug hypersensitivity

Auto-immune Churg-Strauss syndrome
Wegener's granulomatosis
Polyarteritis nodosa
Haematological Hodgkin's disease
Eosinophilic leukaemia
Dermatological Bullous pemphigoid
Pemphigus vulgaris
Respiratory Allergic bronchopulmonary aspergillosis
Hypereosinophilic syndrome
Asthma
Miscellaneous Eosinophilia-myalgia syndrome caused by L-Tryptophan
Spanish toxic oil syndrome
Eosinophilic gastroenteritis

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Copyright: Rob Skelly 2006