From the Research
Mebendazole is a suitable treatment option for parasitic infections that can cause eosinophilia, and its use should be guided by the type of infection and the severity of symptoms, with monitoring of complete blood counts and consideration of corticosteroids if severe eosinophilia develops. When treating parasitic infections with mebendazole, it is essential to be aware of the potential for eosinophilia as a side effect, which occurs due to the release of antigens from killed parasites that trigger an immune response, leading to increased production of eosinophils 1. Eosinophilia is expected during successful treatment of helminthic infections and may temporarily worsen as the parasites die, but this reaction is typically self-limiting and resolves after the infection is cleared 2. Standard mebendazole dosing varies by infection type, with specific regimens for pinworms, whipworms, hookworms, roundworms, and more severe infections like echinococcosis 1. If severe eosinophilia (>1500 cells/μL) develops with concerning symptoms, consider temporarily discontinuing mebendazole and consulting with an infectious disease specialist to determine if corticosteroids might be needed to manage the inflammatory response, as supported by a study on corticosteroids for parasitic eosinophilic meningitis 3. Key considerations in managing eosinophilia associated with mebendazole treatment include:
- Monitoring complete blood counts, especially if symptoms like rash, fever, or respiratory distress develop
- Adjusting mebendazole dosing based on the type and severity of the infection
- Being aware of the potential for eosinophilia and its typical self-limiting nature
- Considering corticosteroids for severe eosinophilia with concerning symptoms, as evidenced by the benefits of corticosteroids in reducing headache duration and analgesic use in patients with eosinophilic meningitis 3.