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UK guidelines for the investigation and management of eosinophilia in returning travellers and migrants.

J Infect

November 2024

Hospital for Tropical Diseases, Capper Street, London, WC1E 6JB, UK; London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. Electronic address:

Eosinophilia is a common finding in returning travellers, migrants and other travelling groups. In this setting it often indicates an underlying helminth infection. Infections associated with eosinophilia are frequently either asymptomatic or associated with non-specific symptoms but some can cause severe disease.

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Introduction: Filarial pathogens are described to inhabit and affect subcutaneous and lymphatic tissues of the human host. To date, little is known on how much oral health might be affected by filarial infections, even though involvement of the oro-facial region is pathophysiologically possible. Therefore, we conducted this systematic review of the literature to help reduce the current evidence gap.

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Elephantiasis, also known as filariasis, is a severe public health issue in India. Microfilariae in the bone marrow smears are an unusual and incidental finding. Every peripheral blood and bone marrow aspirate smear must be screened for microfilariae in endemic areas to identify asymptomatic carriers.

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Article Synopsis
  • * A study examined 100 male dogs over a period of 14 months, finding that 6% tested positive for D. repens in their testes, with microfilariae present in 15 blood samples, leading to a total prevalence of 16%.
  • * No harmful lesions or pathological changes were observed in the testes of infected dogs, indicating that the presence of these parasites doesn't usually cause significant health issues, highlighting the need for better monitoring in areas where the parasite is common to prevent transmission to humans.
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Microfilarial parasites can obstruct the lymphatic tree giving rise to varying lymphatic and extra-lymphatic symptoms. Renal manifestations can range from asymptomatic proteinuria, chyluria, and nephrotic syndrome, to acute glomerulonephritis. The diagnosis of filariasis is usually made by the demonstration of the parasite in the peripheral blood smear, with or without eosinophilia.

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