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Investigation into the cause of elevated eosinophil percentage at the VA Imperial Valley Clinic

Abstract

Eosinophils are a specific type of leukocytes that are often elevated in cases of allergy, parasitic infection, or certain fungal infections. Clinicians at the VA San Diego Healthcare System noticed that many patients happened to have elevated eosinophil percentage when they ordered CBCs. An investigation to quantify the percentage of CBCs with elevated eosinophil count (with a threshold of 3% as determined by the VA Clinical Laboratory) was undertaken at 6 different VA Clinics within the VA San Diego Healthcare system from May 2010 until June 2010. This study found that the VA Imperial Valley Clinic had 50.45% elevated eosinophil percentage, which differed from all other clinic sites in a statistically significant manner. It is thus hypothesized that there may have been an environmental cause for the elevated eosinophil count, especially given that elevated eosinophil percentage varied by geographic location. In this study we set to investigate whether environmental factors such as exposure to fungal infection, parasitic infection, HIV, or common allergens could account for the elevated eosinophil percentage. Of particular interest is exposure to Coccidioides immitis as it is endemic to Southern California.

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