Key Clinical MessageFilariasis may present as an isolated perinephric abscess. Hence, a high index of suspicion should be maintained in endemic settings.AbstractIn cases with unexplained fever, eosinophilia and perinephric collection, it is necessary to do detailed infectious disease work up. High index of suspicion is required to diagnose filariasis due to its wide range of clinical presentation and laboratory findings. It may present as perinephric abscess, which can be diagnosed through ultrasonography.