|Year : 2021 | Volume
| Issue : 2 | Page : 136
The night wanderer: Microfilaria in peripheral blood smear
Vivek Sharma1, Rajiv Sharan1, Santosh Kumar2
1 Department of Pediatrics, Tata Motors Hospital, Jamshedpur, Jharkhand, India
2 Department of Pathology, Tata Motors Hospital, Jamshedpur, Jharkhand, India
|Date of Submission||18-Apr-2021|
|Date of Decision||12-May-2021|
|Date of Acceptance||14-May-2021|
|Date of Web Publication||31-May-2021|
Dr. Vivek Sharma
Department of Pediatrics, Tata Motors Hospital, Jamshedpur - 831 004, Jharkhand
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sharma V, Sharan R, Kumar S. The night wanderer: Microfilaria in peripheral blood smear. Indian Pediatr Case Rep 2021;1:136
Lymphatic filariasis (LF) is caused by Wuchereria bancrofti (90%), Brugia malayi (<10%), and Brugia timori. Over 250 million children are exposed to LF worldwide. Common pediatric manifestations in endemic areas are asymptomatic infection or acute clinical manifestations by 11–15 years of age.
A 13-year-old boy presented with painless swelling over the medial aspect of his left arm that was initially diagnosed as evolving cellulitis and treated with antibiotics. A possibility of LF was considered on finding high total leukocyte counts (10,480/mm3) with 25% eosinophilia. A provocative dose of diethyl carbamazine (DEC) was given, following which a nocturnal blood sample was collected and peripheral smears made. The diagnosis was clinched by identification of the W. bancrofti microfilaria (mf) based on the large size (>200 μm), presence of sheath, short head space, and anucleate tail [Figure 1] and web [video 1]. The child was treated with DEC (6 mg/kg/day).
[Additional file 1]
Microfilariae usually circulate between 10 PM and 2 AM at night, coinciding with the usual feeding timing of mosquitos. the prevalence rate of mf is 30% in children < 10 years and almost 69% in adolescents < 19 years. Two thin and two thick smears are made and stained with Giemsa or Hematoxylin. Species can be determined by the aforementioned morphological characteristics. An entire blood film should be scanned at ×10 before being reported as negative. Other diagnostic modalities include the detection of mf antigen by immune-diagnosis, Doppler sonography, lymphoscintigraphy, and histopathology.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
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Conflicts of interest
There are no conflicts of interest.
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