A Case of Filariasis in a 68 year old Filipino Female

Authors: Fatima DC. Jacinto-Calimag, MD, Maria Franchesca S. Quinio MD, Elizabeth P. Prieto, MD, FPDS

Abstract

Introduction: Filariasis is caused by nematodes (roundworms) that inhabit the lymphatics and subcutaneous tissues. Infections are transmitted by mosquito vectors and humans are definitive hosts. It can be asymptomatic or associated with acute and/or chronic clinical manifestations, including adenolymphangitis, filarial fevers, hydrocele, chronic lymphatic disease, and tropical pulmonary eosinophilia.

Case Summary: 68-year-old, Filipino, female from Sorsogon, Bicol, consulted due to a 10-year history of multiple nodules on the left foot. Past medical and social history, were noncontributory. No history of similar lesions in the family. On physical examination, there were firm, non tender, immobile, well defined, pinkish to brownish lobulated mass topped with verrucous papules and nodules with a thickened hyperkeratotic surface and a moss-covered appearance surrounding the periphery of the left foot. The findings of multiple lymphadenopathy in the ultrasound and the obstruction in the lymphatic vessels seen in the lymphoscintigraphy is consistent with this disease. Biopsy was done and showed fibrosing dermatitis, with absence of bacterial and fungal elements and no evidence of malignancy, supporting our diagnosis of Filariasis. Patient was for excision biopsy of whole lesion with split thickness grafting once cleared with other services, however lost to follow-up.

Conclusion:The treatment of filiariasis is essentially targeted at treating the active infection of Filariasis. Even if the infection is controlled, the lymphatic swelling which have already occurred may not reverse. Surgical treatment may be required in the resistant cases with large swelling and thickening.

 

Citation

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Keywords

filariasis, endemic, Sorsogon

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