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Year : 2011  |  Volume : 36  |  Issue : 2  |  Page : 161-162

Filariasis presented as a spermatic cord nodule in a nonendemic hilly state of Uttarakhand: A case report of second case in the region

Department of Pathology, Uttarakhand Forest Hospital Trust Medical College, Haldwani, Nainital, Uttarakhand, India

Date of Submission12-Oct-2009
Date of Acceptance10-Aug-2010
Date of Web Publication22-Aug-2011

Correspondence Address:
Naveen Thapliyal
Uttarakhand Forest Hospital Trust Medical College, Haldwani, Nainital, Uttarakhand
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0970-0218.84139

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How to cite this article:
Thapliyal N, Bhadani P, Joshi U, Singh S, Jha R S. Filariasis presented as a spermatic cord nodule in a nonendemic hilly state of Uttarakhand: A case report of second case in the region. Indian J Community Med 2011;36:161-2

How to cite this URL:
Thapliyal N, Bhadani P, Joshi U, Singh S, Jha R S. Filariasis presented as a spermatic cord nodule in a nonendemic hilly state of Uttarakhand: A case report of second case in the region. Indian J Community Med [serial online] 2011 [cited 2022 May 27];36:161-2. Available from: https://www.ijcm.org.in/text.asp?2011/36/2/161/84139

   Introduction Top

Filariasis is endemic in many parts of India especially in the southwestern costal region [1] and is caused most frequently by Wuchereria bancrofti. But Uttarakhand is a nonendemic hill state of India for the disease. It is diagnosed by finding the larva or microfilaria in blood, fluids, needle aspirates, and tissues. [2]

The major clinical presentation of lymphatic filariasis includes low-grade filarial fever and lymphatic obstruction. Other symptoms may be malaise, headache, and vague pain. Lymphatics are tender, thickened, firm, and red. The overlying skin is red. [1] Although the filarial worm can be localized anywhere in the body, the usual location is in the inguinal, scrotal, and abdominal lymphatics. [3]

   Case Report Top

A 22-year-old male resident of district Udham Singh Nagar (Bazpur) in Uttarakhand presented to the surgery out-patient department (OPD) of Uttarakhand Forest Hospital Trust Medical College, Haldwani (Nainital), with a complaint of swelling in the left inguinal region. Swelling was painless and was present for more than 1-year duration. On clinical examination, swelling was elongated in shape measuring 3.0 × 1.0 cm. The patient was asymptomatic and looking apparently healthy. There was no history of fever. All the hematological and biochemical parameters were within the normal limit. A clinical diagnosis of lipoma/neurofibroma was made. The swelling was excised and sent for histopathological examination.

Gross examination

One elongated, grayish-white to grayish-brown, firm tissue piece, measuring 3.0 × 1.0 cm was obtained. The cut surface was grayish-white and homogenous.

Histopathological examination

Sections showed presence of multiple adult filarial worms, surrounded by dense inflammatory cell infiltrates predominantly eosinophils. Worms were embedded in the fibrocollagenous tissue, and were densely infiltrated by the inflammatory infiltrate [Figure 1].
Figure 1: Section showing cut sections of the adult filarial worm surrounded by inflammatory cell and fibrocollagenous tissue (H and E, ×100)

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   Discussion Top

Filariasis is a major public problem in many parts of the tropical countries. International Task Force for Disease Eradication has identified lymphatic filariasis as one of the six diseases considered eradicable or potentially eradicable. [4]

India's National Health Policy 2002 has a goal to eliminate the lymphatic filariasis by the year 2015. Filariasis elimination is also a global goal as per WHO resolution. Uttarakhand, a newly formed hill state of India, is nonendemic for filaria. Filarisis caused by W. bancrofti is endemic in many parts of India. Uttarakhand is a nonendemic hill state of India. But filariasis due to W. bancrofti is reported to be increasing as a result of human population in endemic areas and mismanagement of the environment. [5] Being the new state, the development of industrial areas, engineering projects, and population migration particularly from the endemic areas for the search of employment are the major factors for the deforestation and environmental warming as well as the arrival of the agent factor for the disease. Udham Singh Nagar is a foothill district (tarai region) of Uttarakhand and was considered as a nonfilarial region. But the change in environmental conditions, like the increase in temperature and migration of the population from the endemic region of the country, favors the conditions for the vector as well as the agent. We are reporting the present case as the second case of filaria in the Kumaon region of the Uttarakhand as per our best knowledge. The first case was from Nainital, district of Uttarakhand. [6]

   Conclusion Top

Being a second case of filaria in the endemic hill state of Uttarakhand, there is a likelihood of more hidden cases of filaria in the region and therefore, a more intensive survey required for the disease in the region, so that it can be controlled at the earliest stage.

   References Top

1.Bruce M. Greene: Filariasis. Harrison's Principles of Internal Medicine. 12 th ed., Vol. 1 J Wilson et al (eds). pp. 809-10,McGraw Hill, New York 1991.  Back to cited text no. 1
2.Myageri A. Wuchereria Bancrofti adult worms in fine needle aspirate: A case report. J Cytol 2006;23:91-3.  Back to cited text no. 2
3.Pant I, Singh PK, Singh SN, Agarwal A. Filariasis breast: A report of two cases, an unsual site to be involved. J Cytol 2003;20:206-7.  Back to cited text no. 3
4.Sabesan S, Raju HK, Srividya A, Das PK. Delimitation of lymphatic filariasis transmission risk areas. Filaria J 2006;5:12.  Back to cited text no. 4
5.Park K. Epidemiology of communicable diseases: Lymphatic filariasis. In: Park K, editor. Park`s Text Book of Preventive Social Medicine. Jabalpur, India: Banarasidas Bhanot; 2005. p. 211-6.  Back to cited text no. 5
6.Thapliyal N, Joshi U, Bhadani P, Jha RS. First report of Filariasis in a non-endemic hill state of India. Indian J Pathol Microbiol 2009;52:293-4.  Back to cited text no. 6
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