Filarial huge splenomegaly dramatically regressed by anti-filarial medication: A rare clinical scenario

Filariasis presenting with bicytopenia, progressive splenomegaly and acute renal failure: An unusual case report

Extra-lymphatic manifestation of filariasis, especially as acute renal failure, is uncommon and may be clinically unsuspected. We document the case of a 60 year old elderly male who presented with bilateral pedal oedema, fatigue and abdominal distension. Investigations revealed severe anaemia, splenomegaly and acute renal failure. Bone marrow aspiration was performed to evaluate the clinical suspicion of malignancy. Out of eight smears examined, microfilaria (Brugia malayi) were identified in two. This presentation was devoid of peripheral eosinophilia. The patient was commenced on a regimen of diethylcarbamazine, on which he made a good recovery. The incidence of extra-lymphatic filariasis is largely unknown and sparsely reported. Such a presentation should be kept in mind by both clinicians and pathologists as it is potentially treatable.

Atypical cases of filariasis from a non-endemic area

Filariasis can present in many different ways and pose significant dilemma to the clinician. We report four atypical cases of filariasis which presented as abdominal mass, cervical lymph node enlargement, fever in pregnancy and nosocomial febrile illness respectively. All the four cases were treated successfully with oral antifilarial agents. It is essential to be aware of such atypical presentations of filariasis so that prompt therapy can be initiated.