Symptomatic hypereosinophilia associated with Necator americanus self-inoculation

A 2006 systematic review found that, in populations with endemic hookworm infection, there was a reduc-tion in long-term asthma risk in those who were infected, compared with those who were not.1 However,no benefit of helminthic therapy in previously unin-fected patients with asthma and other allergic diseases has been demonstrated in several studies.2A 2012Cochrane review of helminthic therapy for allergic rhini-tis showed no significant reduction in overall medicationuse, although there was less use of rescue medication inone study using pig whipworm.3Despite this lack of evi-dence, the treatment is marketed online for a plethora ofautoimmune, inflammatory and uncategorised condi-tions. As a cautionary tale, we present here the first report of organ damage due to hypereosinophilia after deliberate helminth infection used in an attempt to mod-ulate allergic symptoms.