Whipworm infection resulting in eosinophilic colitis with occult intestinal bleeding

Abstract

An asymptomatic 65-year-old man from India was found to have occult blood in his stool and was referred to our institution for an outpatient colonoscopy. The patient denied any abdominal pain, diarrhea, melena, or hematochezia. Laboratory data revealed a borderline normocytic anemia, with a Hb of 13.7 g/dL (normal, 13.2-16.9 g/dL), a hematocrit of 39.4% (39.6%-50.2%), and mean corpuscular volume of 87.6 fL (76.2-98.6 fL). Other laboratory results included a white blood cell count, 9.38 × 109/L (3.9-10.7 × 109/L), with a normal differential (absolute neutrophils, 5.15 × 109/L [1.8-7.7 × 109/L]; lymphocytes, 3.34 × 109/L [1.0-4.8 × 109/L]; monocytes, 0.53 × 109/L [0.00-1.07 × 109/L]; eosinophils, 0.34 × 109/L [0.00-0.54 × 109/L]; basophils, 0.02 × 109/L [0.00-0.21 × 109/L]); and normal platelet count, 218,000/μL [174,000-404,000/μL].