Filariasis presenting as isolated pleural effusion: A case report and mini review

Abstract

Isolated pleural effusion is a rare manifestation of filariasis that mimics tuberculosis, especially in endemic regions. We describe a case of lymphocytic and exudative pleural effusion showing microfilaria on pleural fluid cytology. A retrospective review of all cases of filarial pleural effusion reported after 2000 was conducted to evaluate the association between filariasis and pleural effusion as well as to screen the features that can help in accurate detection of these patients. The analysis suggested a causal association between the parasite and the development of pleural effusion with a high sensitivity of pleural fluid cytology for diagnosis.

Pleural effusion caused by Trichinella spiralis infection: two case reports

“…The transthoracic echocardiogram showed left ventricular systolic dysfunction (ejection fraction 44%) and moderate pericardial effusion The serologic test for parasites was positive for Toxocara and Sparganum A combination therapy of albendazole (400 mgBID/2 weeks), praziquantel (600 mgTID/1 day), and corticosteroid (60 mgQD/6 days) At Outpatient Clinic follow-ups and observations over the next 2 years there were no abnormal findings, including pericardial effusion or eosinophilia Savu et al [ 14 ] 43/male Romania Hydatidosis caused by the Echinococcus larvae He was a heavy smoker, occasional consumer of ethanol as well as working with livestock as a shepherd Moderate dyspnea, chest pain and weight loss Multiple cystic formations of various sizes and liquid density within the pleural fluid Elevated eosinophil count, Surgery was performed by right lateral thoracotomy and consisted of removal of the hydatid fluid and cysts found in the pleura. IGG-specific ELISA tests(+) Albendazole 15 mg/kg/day for 6 days before surgery, Albendazole treatment for 1 year with 15 mg/kg/day Follow-up showed no signs of recurrence with a normal chest X-ray and an improved lung volume function at one month, 6 months and 1 year Aggarwal et al [ 15 ] 30/male Uttar Pradesh, India Microfilaria/ Filariasis None Low-grade, intermittent fever for two years, right-sided chest pain and weight loss Chest radiography showed a right-sided pleural effusion with normal parenchymal attenuation Fluid cytology showed degenerated lymphocytes along with a few microfilaria, conforming to the morphology of Wuchereria Bancrofti Diethylcarbamazine 300 mg daily in divided doses Chest radiography repeated 6 weeks later showed complete clearance of the effusion Tourne M et al [ 16 ] 39 Paris Cystic echinococcosis, or hydatidosis None Chest pain associated with sweating and chills Thoracic computed tomography shows two large cystic opacities with endocystic flaky images, including one ruptured in the pleura with right pleural effusion Positive hydatidosis serology, and surgery Treatment by albendazole full-recovery …”

Dirofilariasis Presenting as Pleural Effusion: a Rare Case Report With Unusual Manifestations and Treatment Modalities

“…The escalating effects of climate warming, global movement, improved awareness of the infection contribute to the growing morbidity of diro lariasis in humans, underscoring its increasing relevance in contemporary medicine. 11,12 In this report we present an exceptionally rare case of pleural effusion due to diro lariasis. This case marks the rst instance of human pulmonary diro lariasis reported in Lithuania.…”

Assessment of Rare Case on Patient with Filariasis-Associated Bilateral Pleural Effusion

“…Pleural effusion is a rare manifestation of filariasis that may mimic tuberculosis or other causes of effusion. The majority of clients are young to middle age (median) with a mean age of 36 years old, males, and have higher exposure to disease vectors (1).…”

“…Filariasis is often difficult to diagnose, especially in non-endemic areas. A retrospective search of the PubMed database revealed that only 19 cases were reported between 2000 to 2021 (1). Filariasis is a vectorborne tropical disease that attacks the lymph nodes.…”

“…Microfilariae have been identified in the cytological examination of specimens from lymph nodes and any fluid of the body. However, fluid originating from pleural effusion is rare (1). This case study aimed to describe bilateral pleural effusions caused by filariasis and the challenges faced during diagnosis.…”