Abstract: Background: Cystic echinococcosis (CE) is a chronic, complex and neglected zoonotic disease caused by Echinococcus granulosus. Eosinophilia in CE is a classic analytic alteration, although its presentation and importance is very variable and not well established. Methods: We performed a retrospective observational study of inpatients diagnosed with CE and eosinophilia from January 1998 to December 2017 in the Complejo Asistencial Universitario de Salamanca in western Spain. Results: During the study period, 475 patients with a CE diagnosis underwent a haemogram and 118 (24.8%) patients had eosinophilia. Eighty-two (69.5%) were male and the mean age was 52.1±20.8 y, which was younger in the group with eosinophilia (p<0.001). The patients with eosinophilia had less comorbidity (33.1% vs 52.9%; p<0.001) and they were diagnosed with more complications (60.2% vs 39.8% asymptomatic; p<0.001). Clinical manifestations appeared in 71 cases (60.2%). The eosinophilia was related to the presence of pre-surgical fistulas (p=0.005). We observed significant differences when considering whether eosinophilia is a marker of the type of treatment (p<0.001). Conclusions: Eosinophilia can be an indicator for an active search in CE because as much as 40% of cases are asymptomatic at diagnosis. In patients with eosinophilia, management is usually more aggressive and is usually a combined treatment. Our work shows the importance of eosinophilia in our patients with CE and raises unresolved questions.

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