Role of absolute eosinopenia as marker of enteric fever: Experience from a Tertiary Care Hospital in the United Arab Emirates

Lokhandwala, Aliasgar; Athar, Syed; Turrin, Nicolas P.

doi:10.4103/1947-489x.210782

Cited by 6 publications

(10 citation statements)

References 25 publications

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“…Namely, a patient was regarded as having relative bradycardia if the heart rate was less than each of the following criterion: 38.3°C [101°F] with 110 beats per minute (bpm), 38.9°C [102°F] with 120 bpm, 39.4°C [103°F] with 120 bpm, 40.0°C [104°F] with 130 bpm, 40.6°C [105°F] with 140 bpm, and 41.1°C [106°F] with 150 bpm. The optimal cut off value for eosinopenia is still uncertain; however, absolute eosinopenia was defined as an eosinophilic count of 0/μL, and eosinopenia was defined as ≤1% of the white cell differential, based on the previous studies [ 19 – 21 ]. In controls, the category of viral syndrome was defined as systematic viral infections.…”

Section: Methodsmentioning

confidence: 99%

Role of classic signs as diagnostic predictors for enteric fever among returned travellers: Relative bradycardia and eosinopenia

et al. 2017

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BackgroundThe lack of characteristic clinical findings and accurate diagnostic tools has made the diagnosis of enteric fever difficult. We evaluated the classic signs of relative bradycardia and eosinopenia as diagnostic predictors for enteric fever among travellers who had returned from the tropics or subtropics.MethodsThis matched case-control study used data from 2006 to 2015 for culture-proven enteric fever patients as cases. Febrile patients (>38.3°C) with non-enteric fever, who had returned from the tropics or subtropics, were matched to the cases in a 1:3 ratio by age (±3 years), sex, and year of diagnosis as controls. Cunha’s criteria were used for relative bradycardia. Absolute eosinopenia was defined as an eosinophilic count of 0/μL.ResultsData from 160 patients (40 cases and 120 controls) were analysed. Cases predominantly returned from South Asia (70% versus 18%, p <0.001). Relative bradycardia (88% versus 51%, p <0.001) and absolute eosinopenia (63% versus 38%, p = 0.008) were more frequent in cases than controls. In multivariate logistic regression analysis, return from South Asia (aOR: 21.6; 95% CI: 7.17–64.9) and relative bradycardia (aOR: 11.7; 95% CI: 3.21–42.5) were independent predictors for a diagnosis of enteric fever. The positive likelihood ratio was 4.00 (95% CI: 2.58–6.20) for return from South Asia, 1.72 (95% CI: 1.39–2.13) for relative bradycardia, and 1.63 (95%CI: 1.17–2.27) for absolute eosinopenia. The negative predictive values of the three variables were notably high (83–92%);. however, positive predictive values were 35–57%.ConclusionsThe classic signs of relative bradycardia and eosinopenia were not specific for enteric fever; however both met the criteria for being diagnostic predictors for enteric fever. Among febrile returned travellers, relative bradycardia and eosinopenia should be re-evaluated for predicting a diagnosis of enteric fever in non-endemic areas prior to obtaining blood cultures.

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Section: Methodsmentioning

confidence: 99%

Role of classic signs as diagnostic predictors for enteric fever among returned travellers: Relative bradycardia and eosinopenia

et al. 2017

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“…It is seen that eosinopenia often absolute may be present in 70-80% of cases. 4,5 Presence of absolute eosinopenia offers a clue to diagnosis but does not differentiate it from other acute bacterial or viral infections. 11,17,18 In Our study eosinopenia is not a significant finding.…”

Section: Discussionmentioning

confidence: 99%

“…Leukopenia is perceived to be an important feature of typhoid fever and has been reported in only 20-25% cases. 4 The differential count is usually unremarkable except for eosinopenia. Eosinopenia often absolute may be present in 70-80% cases.…”

Section: Introductionmentioning

confidence: 99%

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To study haematological profile of Enteric fever patients.

2017

Int. J. Curr. Res. Med. Sci.

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Introduction: Typhoid fever is a major health problem in developing countries. It is caused by Salmonella typhi and S. paratyphi .In India annual incidence is nearly 1%.Blood culture for Salmonella is the gold standard to diagnose typhoid fever. Hematological profile of these patients is affected by this infection. We took this study to establish the significance of hematological profile in blood culture proven Typhoid fever patients. Material and Methods : We did a cross sectional study on 100 patients attending OPD and IPD of Department of Pediatrics ,with history of fever of >38 0 Cfor 3 days aged 1-14 years. Previously antibiotic treated patients and patients with proven localised infection were excluded .Panel of tests including blood culture and haematological profile (Hemoglobin , TLC ,DLC, Platelet count, ESR) were done on these patients . Results: In our study 46% of our patients were blood culture proven typhoid fever patients. Male children of school going age group were most commonly affected by typhoid fever. We found anemia, leucopenia, thrombocytopenia in 47.8%,6.5%and 21.5% of patients. Lymphocytosis was seen in 10.9 % of patients.ESR was high in 52.2% of patients. Results were comparable to studies done in past but we found that out of all these parameters only ESR was significantly associated with blood culture positivity. Conclusion : Anemia in typhoid fever patients is not because of the salmonella infection .It can be because of other reasons for which detailed blood indices are required to be investigated .Total leucocyte count, eosinophil count and platelet count are also not contributory to diagnosis of enteric fever. High ESR is associated with typhoid fever. Further studies are needed to study the blood indices in detail in patients with typhoid fever in India.

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“…As this is a wide range this series adopted theaverage of the range as the cut off below which thevalue was termed as eosinopeniabut values less than40/cmm was termed as severe eosinopenia. Theeosinophils in the body are normally well regulated (44) .…”

Section: Fig 6: Roc Curve For Eosinophil Count For Mortality Predictmentioning

confidence: 99%

Eosinopenia as a Diagnostic Marker of Sepsis in Critically Ill Patients

Ali

Abdelsamie

2018

Egyptian Journal of Hospital Medicine

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Background: sepsis refers to the presence of a serious infection that correlates with systemic and uncontrolled immune activation. Few studies had analyzed eosinophil count as a prognostic marker of outcome in patients with infection. Eosinopenia is an interesting biomarker because the eosinophil count is always measured in clinical practice and the additional costs would therefore be negligible.The aim of this wrk: this studyaimed to test the value of eosinopenia in the diagnosis of sepsis in critically ill patients admitted to ICUs. Patients and Methods: this prospective observational, randomized study was conducted on 50 adult critically ill patients who were admitted to ICU of Ahmed Maher Teaching Hospitalin the period from March 2017to July 2017. They either had sepsis on admission or not. An informed written consent was obtained from patients and/or relatives before starting this study. Inclusion criteria were patients more than 18 years old and less than 60 years that were critically ill either in sepsis or not. Exclusion criteria were patients less than 18 years old and more than 60 years old, patient or relatives who refused to be included in this study, those with hematological cancer, HIV infection, bronchial asthma and other atopic disorders like hay fever, atopic dermatitis and allergic conjunctivitis and increased levels of eosinophil count as part of any parasitic infection or trauma patients. Results: comparison between infected and non-infected studied patients was statistically significant as regard variables of SOFA score, APACHE II score at admission, TLC and Eosinophil count at admission (p-value˂0.05). There were no statistical significant differences as regard length of ICU stay (p˃0.05). Multivariate regression analysis showed statistically significant differences and was independent predictors for infection as follow: total leucocytic count, eosinophil count at admission and SOFA score. The AUC for eosinophil count to predict was 95% with optimal cut off value was 50 cells/mm 3 with a sensitivity of 92.85% and specificity of 93.33% with P value <0.001.Conclusion: the result of the present study revealed that eosinophil counts was ˂50 cells/mm3 at admission time to ICU was a predictor for diagnosis of sepsis in critically ill patients. However, eosinophil counts at admission time to ICU were not a specific indicator of mortality. Recommendations: eosinophil counts are cheap and easily accessible test can be used to guide for sepsis diagnosis and treatment.Larger studies are needed to determine the prognostic value of this test and establish better cutoff values.

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Role of absolute eosinopenia as marker of enteric fever: Experience from a Tertiary Care Hospital in the United Arab Emirates

Cited by 6 publications

References 25 publications

Role of classic signs as diagnostic predictors for enteric fever among returned travellers: Relative bradycardia and eosinopenia

Role of classic signs as diagnostic predictors for enteric fever among returned travellers: Relative bradycardia and eosinopenia

To study haematological profile of Enteric fever patients.

Eosinopenia as a Diagnostic Marker of Sepsis in Critically Ill Patients

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