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Eosinophilia on Cbc since 2 months
Since November end on Cbc , Absolute eosinophil count is 1367 and in January end it is 1416, My dad got pneumonia in November end and was treated for the same with Faropenam for 7 days and Clarithromycin for 5 days orally . He has recovered well. But 15 days after the treatment , he developed burning sensation in mouth and stiffness, we watched for a few days for it to subside but when it didnt we showed an ent and he diagnosed it as oral lichen planus , and gave steroid cream, which reduced his symptoms a lot. Now in January mid he started having digestive issues, he had bloating and nausea and incomplete evacuation on again off again,no diarrhoea, especially after having fermented foods like idli dosa , not with curd though. Now in January end I got cbc done and it still shows aec of 1416.
How do I proceed?
Answers (13)
Do the following,
1. Blood tests: Blood film, Immunoglobulins, ANA, ANCA, IgA-Aspergillus, HIV, LFT, KFT, Calcium
2. CT thorax abdomen and pelvis (Q1-any cavitating lung lesion Q2- any increase in size of lymph nodes spleen and liver)
All the best.
J G S R clinic
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1️⃣ Confirm it’s persistent
• Repeat CBC with differential (2 readings ≥1–2 weeks apart)
• Look at trend (rising? stable?)
⸻
2️⃣ Common causes to rule out first (MOST IMPORTANT)
A. Parasitic infection (very common in India)
Even without GI symptoms.
• Stool routine & microscopy ×3
• Strongyloides IgG (if available)
• Empirical deworming is reasonable
Treatment (empiric, if no contraindication):
• Albendazole 400 mg once daily × 3 days
• OR single dose, repeat after 2 weeks
• If Strongyloides suspected → Ivermectin 200 µg/kg/day × 1–2 days
⸻
B. Drug-induced eosinophilia
Review last 2–8 weeks:
• Antibiotics (penicillins, cephalosporins)
• NSAIDs
• Antiepileptics
• Herbal / Ayurvedic meds
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An absolute eosinophil count around 1300–1400 is a mild to moderate eosinophilia and is most commonly seen with allergies, parasitic infections, or post-infection inflammatory reactions. It is not usually dangerous by itself, but since it has persisted, it should be evaluated systematically.
Your digestive symptoms may or may not be directly related. I would suggest the following next steps:
• Stool examination (routine and for parasites)• Serum IgE levels• Repeat CBC after 3–4 weeks• Review for any allergy history (food, dust, medications)
For now, maintain a simple, non-irritating diet, avoid fermented/spicy foods if they worsen symptoms, and stay well hydrated. A short course of probiotics can help with bloating and gut discomfort.
Next Steps
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It seems he has landed with irritable bowel now and is very much common with fermented foods and dairy. Though fermented foods are trigger for your case.
Avoid them and give him probiotics like Yakult and coconut water.
If symptoms persist you please consult doctor, a single tab for 3 days and all gone.
Next Steps
Esinophila shows there are chances of mild irritable bowel
Health Tips
Consult if symptoms persist
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