Cervical Lymphatic Filariasis in a Pediatric Patient: Case Report and Database Analysis of Lymphatic Filariasis in the United States

Abstract

Lymphatic filariasis is a mosquito-borne parasitic infection caused by and spp. Commonly seen in tropical developing countries, lymphatic filariasis occurs when adult worms deposit in and obstruct lymphatics. Although not endemic to the United States, a few cases of lymphatic filariasis caused by zoonotic spp. have been reported. Here we present a case of an 11-year-old female with no travel history who was seen in our clinic for a 1-year history of painless left cervical lymphadenopathy secondary to lymphatic filariasis. We review the literature of this infection and discuss the management of our patient. Using the National Inpatient Sample (NIS), the largest publicly available all-payer inpatient care database in the United States, we also examine the demographics of this infection. Our results show that chronic lymphadenopathy in the head and neck is the most common presenting symptoms of domestic lymphatic filariasis. Diagnosis is often made after surgical lymph node excision. Examination of the NIS from 2000 to 2014 revealed 865 patients admitted with a diagnosis of lymphatic filariasis. Most patients are in the mid to late sixties and are located on the eastern seaboard. Eight hundred and twenty six cases (95.5%) were likely due to zoonotic spp. and 39 (4.5%) due to . Despite being rare, these data highlight the need to consider filariasis in patients presenting with chronic lymphadenopathy in the United States.

An uncommon presentation of filariasis: A case report

“…Asymptomatic presentation with only lymph node enlargement has been described in only a few cases (3)(4)(5)(6). In such cases, fine needle aspiration cytology can be used for diagnosis as it is a cheap and accurate method especially in resource limited settings where expensive serological tests are not practical.…”

Filariasis presenting as isolated asymptomatic unilateral inguinal lymphadenopathy

“…5 Superficial sites like lymph nodes, breast lumps, scrotal swellings, thyroid swellings, and soft tissue swellings have very low chances of microfilaria detection. 1,4,[6][7][8][9][10] Only 0.078% of detection rate of microfilaria is noted in all samples of lymph node swellings. 2,11 Treatment is done by diethylcarbamazine, 6 mg/kg/day for a period of 12 days in divided doses.…”

“…2,11 Treatment is done by diethylcarbamazine, 6 mg/kg/day for a period of 12 days in divided doses. 8 A single annual dose of oral Albendazole 400 mg and diethylcarbamazine 6 mg/ kg of body weight is recommended for prevention of filariasis in endemic countries. 5 Vaccines are not effective.…”