Abstract
Introduction: Filariasis is an endemic disease with worldwide distribution in tropical and subtropical regions. It is uncommon in Qatar. The conventional diagnostic procedure is the demonstration of microfilaria in blood smears. Even with its high incidence, it is unusual to detect microfilaria in fine needle aspiration cytology (FNAC) smears. Although the ‘filarial dance sign’ is rarely documented, it remains a classical ultrasonographic sign in lymphatic filariasis. Case presentation: We present a case of a 38-year-old male patient with fever, chills, shortness of breath and a tender warm swelling on his right thigh. Ultrasound of the thigh lesion showed the classical filarial dance sign. Subsequently FNAC from the lesion documented microfilaria in spite of absent peripheral blood eosinophilia and microfilaria. The patient underwent an incision and drainage of the thigh lesion and was treated with ivermectin and diethylcarbamazine. He was subsequently admitted to the medical ward and discharged home after two weeks in a stable condition. Conclusion: This case report illustrates the importance of diagnostic tools like ultrasound and FNAC along with a high index of clinical suspicion while evaluating patients presenting with unusual signs and symptoms. We would like to highlight the rarity of filarial presentation in a nonendemic country like Qatar. This case is unique since microfilaria was demonstrated in the pus aspirated from the thigh abscess and showed the filarial dance sign by ultrasound along with involvement of the pleura and pericardium.
Highlights
Filariasis is an endemic disease in many parts of South East Asia especially South India
The earliest change in lymphatic filariasis is dilation of lymph vessels, which are the habitat of the adult worms, which later on progresses to lymphatic dysfunction
Lymphatic filariasis is a vector borne disease of the tropical and subtropical countries occurring due to infection by filarial worms which invade the lymphatics of humans
Summary
Filariasis is an endemic disease in many parts of South East Asia especially South India. The earliest change in lymphatic filariasis is dilation of lymph vessels, which are the habitat of the adult worms, which later on progresses to lymphatic dysfunction. This commonly manifests as lower limb lymphoedema, hydrocoele, chyluria or rarely groin lymphadenovarix.[1] Axillary lymphovarix is an extremely uncommon presentation of filariasis even in endemic areas. Examination of the smears showed numerous microfilariae in a background of few. 1 and 2) Following this an ultrasound of the swelling was done and this revealed a cystic mass with dilated lymphatic channels. Patient was advised treatment with diethylcarbamazine citrate He did not report back after completion of the treatment
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
