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Pleural fluid eosinophilia in Regional Institute of Medical Sciences, Imphal, Manipur, India

The causes of pleural fluid eosinophilia have been a controversial issue. This prospective study was conducted in RIMS, Imphal with objectives to find out the causes of pleural fluid eosinophilia (PFE), prevalence rate, explore its clinical importance and to evaluate the outcome of treatment. A total of 53 patients who presented in the Respiratory Medicine Department of Regional Institute of Medical Sciences, Imphal with PFE were analyzed from October 2012 to September 2014. Prevalence rate was found to be 7.89%. Out of the 53 patients, 35 (66%) were males and 18 (34%) were females with age ranging from 16 to 86 years (mean age: 47.43 ± 18.34). The causes were paragonimiasis: 15 (28.30%); tuberculosis: 10 (18.87%); carcinoma: 8 (15.09); parapneumonic effusions: 6 (11.32%); pneumothorax: 5 (9.43%); haemothorax: 4 (7.55%); Meig′s Syndrome and amoebiasis: 1 each (1.89%) and unknown: 3 (5.66%). It occurred mainly in people from rural areas (64.2%) and most of them were Christians (49.05%). The majority of effusion associated was seen to be exudative effusion (94.3%) and maximum cases (60.4%) had peripheral blood eosinophilia (>500 eosinophils/cumm of whole blood). All the cases were given appropriate treatment according to the aetiology and all the treatable causes recovered satisfactorily. It concluded that young Christian males from rural and mostly hilly regions of Manipur have PFE due to Paragonimiasis which is due to consumption of undercooked crabs or snails which are the hosts of Paragonimus species and PFE with blood eosinophilia is associated with non-malignant conditions.