Refractory chyluria due to filariasis.

Abstract

repeated examinations for microfilaremia at midnight did not detect the parasite at all. Medical therapy was initiated with dietary restriction and oral administration of ezetimibe; however, the treatment did not improve the symptoms. Subsequently, a combination of DEC and doxycycline was administered, then, chyluria promptly and successfully disappeared. Wuchereria bancrofti has been gradually eradicated, and physicians in developed countries are not familiar with filariasis [2]. The parasitosis is generally treated with anti-filarial drugs and a fat-restricted diet; however, success rate of such medical therapy is only about 70 % with a mean follow-up period of 2 years [3]. Filariasis potentially causes refractory chyluria by forming lymphorrhea between urinary and lymphatic tracts as shown in the present case. Physicians outside endemic areas may need to be aware of the refractory parasitic disease in this borderless era.