The Case ∣ A Senegalese man with gross hematuria

Imported Loa loa filariasis: three cases and a review of cases reported in non-endemic countries in the past 25 years

“…These 52 cases, plus the expatriate patient described in the case reports above, are summarized in Table 2. Sixty-one cases (60.4%) were reported from Europe 8,12,16,17,[19][20][21]24,[26][27][28][29][31][32][33][34][35][36][37]42,43,[45][46][47][48][51][52][53][54]56,59,61,63,64,67,69,70,[72][73][74]77,[79][80][81][82][83][86][87][88][90][91]<...>…”

“…The African country of acquisition of loiasis was not specified in nine cases; 8,11,14,16,29,49,61,73,89 56 Cameroon and Congo, 59 and Cameroon, Nigeria, and Niger 66 ). Microfilaremia was more common in immigrants (78.0%) 7,13,[21][22][23]26,31,35,37,39,40,47,48,52,58,61,63,67,70,74,75,80,82,[85][86][87][88]91,92 (including PR cases) than in expatriates and travelers (Table 3). In contrast, peripheral blood eosinophilia (95.3%) [8][9][10][11][12]14,16,[18]…”

“…Four patients also experienced subcutaneous worm migration 7,42,70 (and PR). Other unusual manifestations included pulmonary involvement, 58,63,68,79 acute arthritis, 52,54,59 carpal tunnel syndrome, 56 calcified breast nodules containing the nematode, 25,53,55,57,72 skin nodules, 25 splenic lesions, 66,90 vein thrombosis, 69 nephrotic syndrome, 48,67,73,86,88 infertility, 61,85 and peripheral neuropathy. 90 Apart from detection in peripheral blood, microfilariae were detected in ascitic fluid, 51 pleural effusion, 58,79 and bronchoalveolar lavage, 68 ovarian follicular fluid, oocytes, and cervicovaginal cytology specimens, 61,78,85 breast and kidney biopsies, 48,55,57,67,86 knee effusion, 52 cerebrospinal fluid and urine, 86 and from spleen tissue after splenectomy.…”

“…Other unusual manifestations included pulmonary involvement, 58,63,68,79 acute arthritis, 52,54,59 carpal tunnel syndrome, 56 calcified breast nodules containing the nematode, 25,53,55,57,72 skin nodules, 25 splenic lesions, 66,90 vein thrombosis, 69 nephrotic syndrome, 48,67,73,86,88 infertility, 61,85 and peripheral neuropathy. 90 Apart from detection in peripheral blood, microfilariae were detected in ascitic fluid, 51 pleural effusion, 58,79 and bronchoalveolar lavage, 68 ovarian follicular fluid, oocytes, and cervicovaginal cytology specimens, 61,78,85 breast and kidney biopsies, 48,55,57,67,86 knee effusion, 52 cerebrospinal fluid and urine, 86 and from spleen tissue after splenectomy. 66 Of those patients presenting with ocular loiasis, 21 were treated with medical therapy (15 with DEC, two with DEC plus mebendazole, two with albendazole, one with ivermectin, and one with ivermectin plus DEC) associated with surgical extraction of the adult worm from the eye.…”

“…66 Ivermectin was employed alone in two patients, 67,84 and followed by DEC or albendazole in five patients. 63,85,86,90,91 Two patients treated with multiple unsuccessful courses of DEC were subsequently treated with albendazole, 25 whereas another two patients were treated with albendazole plus DEC. 79,83 Albendazole alone was employed in two patients. 77,81 Finally, in another four cases the drug used was not specified.…”