Dubai Medical Journal
ISSN: 2571-726X
Pioneering research in medicine, health sciences, nursing, pharmaceuticals, and laboratory work
Should Serum Eosinophil Count Be Considered When Treating Pneumonia?
Published date: Dec 31 2025
Journal Title: Dubai Medical Journal
Issue title: Dubai Medical Journal (DMJ): Volume 8, Issue 4
Pages: 427-435
Authors:
Abstract:
Aim: Eosinopenia is recognized as a potential indicator of infection, particularly in elderly patients and those requiring intensive care. While its established role in sepsis and various bacterial infections is documented, there are limited data on the impact of eosinophil levels in community-acquired pneumonia. This study aims to evaluate the association between low eosinophil counts and the predictive outcomes of pneumonia.
Materials and Methods: Patients admitted with community-acquired pneumonia in our clinic between January and July 2023 were retrospectively evaluated. The demographic, clinical, and laboratory data, comorbidities, length of hospital stay, need for oxygen treatment, or non-invasive mechanical ventilation (NIV) support, and outcome of the infection were recorded. Additionally, complete blood count and biochemical test results were collected.
Results: The study population comprised 116 patients (62 female and 54 male), with a mean age of 68.27±14.67 (21-91). Oxygen support was needed in 56 patients, while 21 cases required NIV; 21 patients were admitted to the intensive care unit (ICU), and 11 patients succumbedto the infection. Although no significant difference was found in eosinophil counts and percentages between patients requiring oxygen and those who did not, or between ICU admissions and discharges, a statistically significant difference was observed between patients who died and those who survived (P < 0.001). Notably, 91% of the deceased cases exhibited absolute eosinopenia (eosinophil count < 50/μL). Receiver operating characteristic (ROC) analysis indicated that eosinophil counts below 15/μL predicted mortality.
Discussion: In our study, eosinopenia observed at hospital admission was identified as a significant marker of mortality in community-acquired pneumonia.
Conclusion: Our findings suggest that eosinopenia, which is readily detectable in routine complete blood counts can serve as a valuable prognostic indicator in pneumonia cases.
Keywords: pneumonia, eosinophil, eosinopenia, prognosis
References:
[1] Kanberoğlu G, Bağ Ö, Karaarslan U,Öztürk S, Ecevit Ç, Öztürk A. The importance of the presence of eosinopenia in the diagnosis of bacterial infection. Turk J Pediatr Dis. 2015;4:239–242. 10.12956/tjpd.2015.144
[2] Al Duhailib Z, Farooqi M, Piticaru J, Alhazzani W, Nair P. The role of eosinophils in sepsis and acute respiratory distress syndrome: A scoping review. Can J Anaesth. 2021 May;68(5):715–726. https://doi.org/10.1007/s12630-021-01920-8 PMID:33495945
[3] Partouche B, Pepin M, de Farcy PM, Kahn JE, Sawczynski B, Lechowski L, et al. Persistent eosinopenia is associated with in-hospital mortality among older patients: Unexpected prognostic value of a revisited biomarker. BMC Geriatr. 2021 Oct;21(1):557. https://doi.org/10.1186/s12877-021-02515-0 PMID:34649512
[4] Abidi K, Khoudri I, Belayachi J, Madani N, Zekraoui A, Zeggwagh AA, et al. Eosinopenia is a reliable marker of sepsis on admission to medical intensive care units. Crit Care. 2008;12(2):R59. https://doi.org/10.1186/cc6883 PMID:18435836
[5] Ata A, Anil M, Helvaci M. The role of eosinopenia in the diagnosis of bacterial infection in children. Pa Med J. 2022;15:467–473. https://doi.org/10.31362/patd.1021300
[6] Long SS, Vodzak J, Storch GA. Use of common clinical laboratory tests to access infectious and inflammatory diseases. In: Long SS. Principles and practice of pediatric infectious diseases (6th edition). Elsevier;2023;1484–1498. https://doi.org/10.1016/B978-0-323-75608-2.00288-3
[7] Carlson TJ, Endres BT, Le Pham J, Gonzales-Luna AJ, Alnezary FS, Nebo K, et al. Eosinopenia and binary toxin increase mortality in hospitalized patients sith Clostridioides difficile infection. Open Forum Infect Dis. 2020 Jan;7(1):ofz552. https://doi.org/10.1093/ofid/ofz552 PMID:31993458
[8] Garcia-Vidal C, Fernández-Sabé N, Carratalà J, Díaz V, Verdaguer R, Dorca J, et al. Early mortality in patients with community-acquired pneumonia: Causes and risk factors. Eur Respir J. 2008 Sep;32(3):733–739. https://doi.org/10.1183/09031936.00128107 PMID:18508820
[9] Alaeddine R, Chirine M, Houda R, Mehdi A, Faten M, Amel K, et al. Poor prognostic factors in acute community-acquired pneumonia. Eur Respir J. 2023;62(suppl 67):PA5116. https://doi.org/10.1183/13993003.congress-2023.PA5116.
[10] Jensen JU, Heslet L, Jensen TH, Espersen K, Steffensen P, Tvede M. Procalcitonin increase in early identification of critically ill patients at high risk of mortality. Crit Care Med. 2006 Oct;34(10):2596– 2602. https://doi.org/10.1097/01.CCM.0000239116.01855.61 PMID:16915118
[11] Aygun G. Diagnosis of sepsis. In: Sepsis in the Light of Current Knowledge. Istanbul University Cerrahpasa Medical Faculty Continuing Medical Education Activities, Symposium Series. No: 51. Istanbul: 2006. p. 51–60.
[12] Bass DA, Gonwa TA, Szejda P, Cousart MS, DeChatelet LR, McCall CE. Eosinopenia of acute infection: Production of eosinopenia by chemotactic factors of acute inflammation. J Clin Invest. 1980 Jun;65(6):1265–1271. https://doi.org/10.1172/JCI109789 PMID:7410543
