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The Lack of Association of Eosinophilia and Neurocysticercosis at Clinical Presentation: A Retrospective Analysis of Cases Seen at the National Institutes of Health, 1985–2015

JeanAnne M. WareLaboratory of Parasitic Diseases, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.

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Theodore E. NashLaboratory of Parasitic Diseases, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.

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Abstract

Eosinophilia is a common laboratory finding in helminth infections but whether it is suggestive of neurocysticercosis (NCC) is controversial and inadequately studied. We determined the presence of eosinophilia (≥ 500 eosinophils/mm3) at clinical presentation in 72 patients with a proven or probable diagnosis of NCC and who had not received corticosteroids within 2 weeks of evaluation and complete blood count. Only two persons whose last possible endemic exposures to NCC were 7 and 6 years earlier had eosinophilia of 500 eosinophils/mm3 and both had a positive antibody serology to strongyloidiasis. In the one subject where a follow-up assessment was possible, the eosinophilia resolved. The likely cause for eosinophilia in both was strongyloidiasis. Therefore, none of the subjects with newly diagnosed NCC had significant eosinophilia. Eosinophilia in newly diagnosed symptomatic NCC subjects who had remote exposure is unusual and should prompt a search for another process or infection.

Author Notes

* Address correspondence to Theodore E. Nash, National Institutes of Health, 9000 Rockville Pike, Building 4, Room 424, Bethesda, MD 20892. E-mail: tnash@niaid.nih.gov

Financial support: This work was supported by the Intramural Research Program of the National Institute of Allergy and Infectious Diseases, National Institutes of Health.

Authors' addresses: JeanAnne M. Ware and Theodore E. Nash, Laboratory of Parasitic Diseases, National Institutes of Health Clinical Center, Bethesda, MD, E-mails: warejm@niaid.nih.gov and tnash@niaid.nih.gov.

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