|IMAGE IN HEMATOLOGY
|Year : 2022 | Volume
| Issue : 3 | Page : 162
A neglected tropical disease (Microfilariasis) in an immunocompromised adult
Malvika Gaur1, Tushar Sehgal2, Arulselvi Subramanian1
1 Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India
2 Department of Laboratory Medicine (Hematology), All India Institute of Medical Sciences, New Delhi, India
|Date of Submission||21-Jul-2021|
|Date of Decision||15-Sep-2021|
|Date of Acceptance||15-Sep-2021|
|Date of Web Publication||15-Sep-2022|
Dr. Tushar Sehgal
Department of Laboratory Medicine (Hematology), All India Institute of Medical Sciences, New Delhi
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Gaur M, Sehgal T, Subramanian A. A neglected tropical disease (Microfilariasis) in an immunocompromised adult. J Appl Hematol 2022;13:162
A 45-year-old male, factory worker by occupation and resident of North-Eastern India came to emergency with occupational trauma to the right forearm. History was significant for hepatitis B infection. CBC showed hemoglobin of 13.5 g/dl, total leukocyte count of 5.6 × 109/L, and platelet count of 151 × 109/L. His absolute eosinophil count was increased at 1180/mm3. Blood film showed a “ribbon-”like structure under low-power view. High-power view showed a curved and sheathed hemoparasite consistent with microfilariae Wuchereria bancrofti (WB) [Figure 1]. The patient was completely asymptomatic. He was later started on oral drug, diethylcarbamazine and continues to do well after 3 months of follow-up. Lymphatic filariasis (LF) is a vector-borne infection classified under the WHO category of “Neglected Tropical Disease.” It is a pertinent public health problem in tropical countries like India. Causative agents are filarial nematodes such as WB, Brugia malayi, and Brugia timori. The vectors transmitting the parasite include species of Anopheles, Culex, Aedes, and Mansonia mosquitoes. LF may present as asymptomatic microfilaremia, lymphatic obstruction, or tropical pulmonary eosinophilia. Association of LF in this case was a tricky one. It raises the discussion whether they are accidental or if immunocompromised patients are more prone to LF.
|Figure 1: Blood film shows a sheathed microfilaria with a smooth and curvy appearance. It has regularly spaced nuclei, however, the nuclei are absent in the tail suggestive of Wuchereria bancrofti infection (May-Grunwald-Giemsa, ×1000)|
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