Periocular filarial lymphoedema

Abstract

Nine filarial species infect man but the lymphatic dwellers Wuchereria bancrofti, Brugia malayi and the subcutaneous Onchocerca volvulus are responsible for most infections worldwide. The species most commonly involved in lymphatic filariasis are W bancrofti, B malayi and B timori of which bancroftian filariasis is the most frequent. B malayi is mostly confined to South-East Asia [1]. B timori is restricted to Indonesian islands [2]. The common manifestations of lymphatic filariasis include asymptomatic microfilaraemia, early filariasis (filarial fever, lymphadenitis, lymphangitis, funiculitis, epididymitis, filarial orchitis and filarial abscess), chronic obstructive filariasis (lymph node enlargement, thickened lymphatic channels, hydrocele, chyluria, chylocele, chylous ascitis, chylous diarrhoea, elephantiasis and lymphoedema) and occult filariasis (tropical pulmonary eosinophilia, filarial arthritis, diffuse mesangial proliferative glomerulonephritis, pericardial and endomyocardial fibrosis, raised intracranial pressure with nerve palsies and allergic response to helminths leading to vesiculobullous lesions and urticaria). Though involvement of the eye in lymphatic filariasis has been reported, it is rare. We report a rare case of filarial lymphoedema involving the periocular tissues.