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Lymphatic filariasis in Australia: an update on presentation, diagnosis and treatment
Author(s) -
Jeremiah Cameron J,
Aboltins Craig A,
Stanley Peter A
Publication year - 2011
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2011.tb03154.x
Subject(s) - presentation (obstetrics) , citation , medicine , lymphatic filariasis , library science , surgery , filariasis , immunology , computer science , helminths
Patient 1 A 28-year-old man presented to the emergency department with a 2day history of a right groin lump, scrotal discomfort and swelling. He was systemically well without urinary symptoms. The patient was born in Burma (Myanmar), and had migrated to Australia 6 years previously after living in Singapore for 2 years. On examination, there was an irreducible mass in the right inguinal canal, associated right scrotal swelling, and a normal testis. There was no peripheral blood eosinophilia. Ultrasonography showed a 1.1 cm heterogeneous right inguinal canal mass thought to be an incarcerated inguinal hernia. An inguinal incision was performed, and a mass attached to the spermatic cord was found and excised. Histopathology of the mass was consistent with filariasis (figure). Filarial serology (IgG enzyme immunoassay [EIA], Westmead Hospital, Sydney, NSW) was positive, but no microfilariae (filarial larvae) were seen on a blood film taken at 4 pm. The patient was treated with doxycycline 100 mg twice daily for 10 weeks and diethylcarbamazine 400 mg daily for 5 days, followed by 400 mg at 1 week and 1 month. Eighteen months later, the patient’s symptoms had not recurred.