Thread by @febrilepodcast

1/
In the newest episode, @JillWeather spoke about eosinophilia!

#1 step: calculate your absolute eosinophil count (AEC).

You can then grade eosinophilia based on AEC (mild/mod/severe)👉although this doesn't exactly predict organ damage

What else?

2/
The ddx for eosinophilia is broad! It can help to think of different causes in groups.

Here is a nice mnemonic and graphic from @HawraAllawati on how she remembers: iPa3d!

I nfection
P arasite
A3 atopy, autoimmune, adrenal insufficiency
D rug rxn

3/
Another memory tool is 3 Ws:
🪱Worms: helminth infections
🫁Wheezes: allergic/atopic, adverse drug reactions
🤪Weird diseases: hypereos syndromes, rare immunodef

Here is a nice review on a practical approach to pt with hypereosinophilia: pubmed.ncbi.nlm.nih.gov/20538328/

4/
Most infections do NOT cause eosinophilia, and not every helminth inf = ⬆️eos.

As @JillWeather noted, eosinophils are largely found in tissue 👉so 🪱 need to be in contact with host tissue to ⬆️eos

Whether it causes none; acute; or acute+chronic eos depend on the life cycle

5/
We won't cover every single infection leading to eosinophilia, but this graphic highlights some common culprits from the ID perspective.

Note that the starred ones are infections that pts may acquire w/o a significant travel hx out of the US 🇺🇸

@HawraAllawati

6/
Take a look at this review of eosinophilia in ID!
pubmed.ncbi.nlm.nih.gov/26209897/

7/
Or take a peek at @JillWeather's thread on this as well if you didn't catch it!

https://twitter.com/JillWeather/status/1368986687032934403

8/
No spoilers in this thread, but we'll have some graphics coming out soon on the culprit of this episode!! @Marcelaaos

Stay tuned!

#IDTwitter #IDMedEd #MedTwitter #MedPeds #PedsID