Remember eosinophilia: DNAAACP or "D N triple A CP"
Fire ants don't cause eosinophilia*
Ascaria is a pulmonary helminth and O and P is positive
Scabies usually in the webs of fingers and causes mite burrows and papules
Cutaneous larva migrans causes intensely pruritic serpiginous lesions anywhere that has come in contact with contaminated sand or soil
Serpiginous = hooks on your foot = hookworms
(*Or do they???
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096327/)
Its not Fire ant. because if it was he would notice instantly. Intense pain followed by intense pruritus.
Hypereosinophilic syndrome is a disease characterized by a persistently elevated eosinophil count (โฅ 1500 eosinophils/mmยณ) in the blood for at least six months without any recognizable cause, with involvement of either the heart, nervous system, or bone marrow.[2]
HES is a diagnosis of exclusion
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