Diagnostic Value of Absolute Eosinopenia as an Early Surrogate Marker in Enteric Fever – A Retrospective Observational Study

Abstract

INTRODUCTION: India has the highest enteric fever burden in Southeast Asia. Currently, blood culture is the gold standard, however, its value is limited due to delayed results. Widal is used in low-resource settings despite its low specificity. This study tends to ascertain the potential of absolute eosinopenia as an early marker in laboratory-confirmed cases of enteric fever; to analyse its association with in-hospital events; and to obtain its occurrence in different serovars of Salmonella.

METHODS: This is a two-year hospital-based retrospective observational study involving 39 patients in a Tertiary Care Hospital at Puducherry. Patients with enteric positive bodily fluid culture or Widal were included. Those with known comorbidities affecting eosinophil counts, mixed growth in culture, antibiotic usage before admission, and antenatal women were excluded. AEC of 0 was considered significant. Data was analyzed using descriptive and inferential statistics. A p-value of <0.05 was considered significant.

RESULTS: Absolute eosinopenia was observed in 71.80% (n=39). Significant correlation was observed between eosinopenia and systemic signs, with the most common being abdominal tenderness in 12 patients. No significant correlation of eosinopenia with in-hospital events or type of serovar was observed.

DISCUSSION: This study demonstrated a strong correlation between absolute eosinopenia and enteric fever. With the right clinical suspicion, absolute eosinopenia has a prospective use as a viable diagnostic marker of enteric fever for physicians with limited resources.