Low density microfilaraemia as a causative agent in a case of unexplained ascitis of suspicious nature

It is estimated that 120 million people worldwide are affected by filariasis. In the South East and South Asian region, Wuchereria bancrofti is the most prevalent parasite causing filariais in 99.4 % of cases. In the present case the parasite was a cause of unexplained ascitis in a young female whose previous cytological report was suspicious in nature. Extensive physical and radiological assesment was not able to determine the cause of ascitis. Repeat cytological examinantion revealed a few microfilariae of Wuchereria bancrofti. The patient was diagnosed as a case of low density microfilaremia and was put on anti-filarial therapy subsequent to which ascitis of the patient regressed. In this case, the clinical picture did not give a clue regarding the aetiology of the ascites. There was no evidence suggestive of filariasis, such as lymphoedema or hydrocele except mild eosinophilia. Circumstantialtial evidence regarding the aetiology of the effusion in our patient included her recovery following antifilarial therapy. The cytological diagnosis of Mf in this patient avoided further expensive investigations and the patient responded to antifilarial therapy.