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Abstract

. Lymphatic filariasis (LF) and leprosy are both endemic in India. These diseases are on the World Health Organization (WHO) list of neglected tropical diseases (NTDs), as they affect the most marginalized communities in the world, resulting in deformities and functional limitation. We report the first case of asymptomatic filariasis and leprosy co-morbidity in a patient with suspected Guillain–Barré syndrome.

. A 55-year-old male who was a farmer by occupation presented to the Neurology Outpatient Department (OPD) of our institute with complaints of weakness in all four limbs for the last 15 days. After admission, a detailed history revealed that the patient had been taking multi-drug therapy (MDT) for leprosy for the previous 6 months. After symptomatic management of the presenting complaints, the patient was sent to the Department of Microbiology for a consultation and six-site slit-skin sampling. The initial screening of Ziehl–Neelsen (ZN)-stained smears under a 10× objective led to the incidental finding of sheathed structures resembling microfilaria (Mf) on the smear made from ear lobules. In addition, short acid-fast bacilli (AFB) were also observed under the oil-immersion objective.

. We emphasize that a high index of suspicion and thorough screening of smears by a microbiologist is essential in specimens obtained from any body site.

  • This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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2019-07-26
2024-04-18
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References

  1. World Health Organization Neglected Tropical Diseases, Hidden Successes, Emerging Opportunities Geneva: World Health Organization; 2009
    [Google Scholar]
  2. Mackey TK, Liang BA, Cuomo R, Hafen R, Brouwer KC et al. Emerging and reemerging neglected tropical diseases: a review of key characteristics, risk factors, and the policy and innovation environment. Clin Microbiol Rev 2014; 27:949–979 [View Article]
    [Google Scholar]
  3. World Health Organization Progress Report 2000-2009 and Strategic Plan 2010-2020 of the Global Programme to Eliminate Lymphatic Filariasis: Halfway Towards Eliminating Lymphatic Filariasis Geneva: World Health Organization; 2010
    [Google Scholar]
  4. World Health Organization Global leprosy strategy. 2016–2020
  5. World Health Organization Lymphatic Filariasis: a Handbook of Practical Entomology for National Lymphatic Filariasis Elimination Programmes World Health Organization; 2013
    [Google Scholar]
  6. Chatterjee KD. Phylum Nemathelminthes . In Chatterjee D. editor Parasitology (Protozoology and Helminthology New Delhi: CBS Publishers & Distributors Pvt Ltd; 2011 pp 236–249
    [Google Scholar]
  7. Mackie TJ, Collee JG, McCartney JE et al. Mycobacterium. Mackie and Mccartney Practical Medical Microbiology New Delhi (India): Elsevier; 2011 pp 329–339
    [Google Scholar]
  8. World Health Organization Guidelines for the diagnosis, treatment and prevention of leprosy; 2018
  9. Cousins S. Experts fear a resurgence of leprosy in India. The Lancet 2018; 392:624–625 [View Article]
    [Google Scholar]
  10. Rao PN, Suneetha S. Current situation of leprosy in India and its future implications. Indian Dermatol Online J 2018; 9:83 [View Article]
    [Google Scholar]
  11. National leprosy eradication programme (NLEP). http://nlep.nic.in/guide.html
  12. Module for skin smear technique for GHC lab technician. http://cltri.gov.in/services/Skin
  13. Willison HJ, Jacobs BC, van Doorn PA. Guillain-Barré syndrome: surveillance and cost of treatment strategies – authors' reply. The Lancet 2017; 389:253–254 [View Article]
    [Google Scholar]
  14. Rawson TM, Rao PVR. Leprosy and lymphatic filariasis comorbidity: the case for an integrated functional limitation grading system. Lepr Rev 2014; 85:63–68
    [Google Scholar]
  15. Brandsma JW, Van Brakel WH, Brakel WV. Who disability grading: operational definitions. Lepr Rev 2003; 74:366–373
    [Google Scholar]
  16. Molyneux DH. Advancing toward the elimination of lymphatic filariasis. N Engl J Med 2018; 379:1871–1872 [View Article]
    [Google Scholar]
  17. Gedge LM, Bettis AA, Bradley MH, Hollingsworth TD, Turner HC. Economic evaluations of lymphatic filariasis interventions: a systematic review and research needs. Parasit Vectors 2018; 11:75 [View Article]
    [Google Scholar]
  18. Nathan MB, Raccurt C. Higher concentrations of microfilariae in capillary blood from the ear lobe than from the finger in wuchereria bancrofti and mansonella ozzardi infections. Trans R Soc Trop Med Hyg 1979; 73:455–457 [View Article]
    [Google Scholar]
  19. Chatterjee KD. Diagnostic Procedures. In Chatterjee D. editor Parasitology (Protozoology and Helminthology New Delhi: CBS Publishers & Distributors Pvt Ltd; 2011 pp 266–273
    [Google Scholar]
  20. World Health Organization 489 global programme to eliminate lymphatic filariasis: progress report, 2014. Wkly Epidemiol Rec 2015; 90:489–504
    [Google Scholar]
  21. Irvine MA, Stolk WA, Smith ME, Subramanian S, Singh BK et al. Effectiveness of a triple-drug regimen for global elimination of lymphatic filariasis: a modelling study. Lancet Infect Dis 2017; 17:451–458 [View Article]
    [Google Scholar]
  22. Gyapong JO, Owusu IO, da-Costa Vroom FB, Mensah EO, Gyapong M. Elimination of lymphatic filariasis: current perspectives on mass drug administration. Res Rep Trop Med 2018; 9:25–33 [View Article]
    [Google Scholar]
  23. Khan AM. Lymphatic filariasis elimination programme in Assam, India, needs change in mass drug administration strategy to target the focus of infection. Indian J Med Res 2018; 147:7 [View Article]
    [Google Scholar]
  24. World Health Organization Guideline: Alternative Mass Drug Administration Regimens to Eliminate Lymphatic Filariasis World Health Organization; 2017
    [Google Scholar]
  25. Wynd S, Melrose WD, Durrheim DN, Carron J, Gyapong M. Understanding the community impact of lymphatic filariasis: a review of the sociocultural literature. Bull World Health Organ 2007; 85:493–498 [View Article]
    [Google Scholar]
  26. Dhanya CSR, Jayaprakash HT, Microfilariae JHT. Microfilariae, a common parasite in an unusual site: a case report with literature review. J Clin Diagn Res 2016; 10:ED08 [View Article]
    [Google Scholar]
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