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Case Reports
. 2019 Jul 26;1(8):e000046.
doi: 10.1099/acmi.0.000046. eCollection 2019.

Asymptomatic filariasis and leprosy co-morbidity in a patient with suspected Guillain-Barrè syndrome: the first case report of an incidental finding in a slit-skin smear

Soumyabrata Nag  1 , Sneha Gupta  1 , Juhi Sisodia  1 , Richa Misra  1
Affiliations
Case Reports

Asymptomatic filariasis and leprosy co-morbidity in a patient with suspected Guillain-Barrè syndrome: the first case report of an incidental finding in a slit-skin smear

Soumyabrata Nag et al. Access Microbiol. .

Abstract

Introduction: 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.

Case presentation: 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.

Conclusion: 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.

Keywords: Lymphatic filariasis; leprosy; neglected tropical diseases.

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Conflict of interest statement

The authors declare that there are no conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Hypopigmented and anaesthetic patches (yellow circles) on skin over right scapula and left deltoid region.
Fig. 2.
Fig. 2.
Sheathed Mf observed in slit-skin smear from ear lobule stained using the Ziehl–Neelsen method with 5 % sulphuric acid as a decolourizer (magnification, 10×).
Fig. 3.
Fig. 3.
Mf observed in Giemsa-stained peripheral blood smear. (Magnification, 10×). Note the absence of nuclei at the tail tip.
See this image and copyright information in PMC

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References

    1. World Health Organization . Neglected Tropical Diseases, Hidden Successes, Emerging Opportunities. Geneva: World Health Organization; 2009.
    1. 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. doi: 10.1128/CMR.00045-14. - DOI - PMC - PubMed
    1. 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.
    1. World Health Organization Global leprosy strategy. pp. 2016–2020.
    1. World Health Organization . Lymphatic Filariasis: a Handbook of Practical Entomology for National Lymphatic Filariasis Elimination Programmes. World Health Organization; 2013.

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