Eosinophilia secondary to strongyloides in Rhode Island.

With an increase in travel and an influx of immigrants and refugees from the tropics over the last few decades, clinicians in Rhode Island are more commonly encountering tropical diseases. The Federation for American Immigration Reform estimated that the average annual rate of increase in the foreign-born population in Rhode Island to be 2400 persons, with the Dominican Republic and Guatemala two of the largest countries from which people emigrate. As a result, hematologic abnormalities such as eosinophilia can arise without any other symptoms, perplexing clinicians as to the proper workup. Hematologists at The Rhode Island Hospital have noticed a significant increase in referrals of eosinophilia with mild leukocytosis or anemia, making it important to discuss major causes in immigrant populations. Infections such as hookworm and Strongyloides stercoralis (Strongyloides) are the most common parasitic nematodes to cause eosinophilia in tropical and subtropical areas. We present a case to illustrate the workup of eosinophilia and to describe the diagnosis and treatment of Strongyloides.