Image 56: This teenager emigrated from Bihar, India 4 years ago and returned to Bihar in 2005 for two months Otherwise well, he presented at our center in August 2007 with a 3 day history of a cord-like non-itchy subcutaneous mass on the medial side of his upper right. It was not painful but was minimally tender. He had no lymphadenopathy, He denied any trauma, had no fever, but had peripheral eosinophilia of 900/µL What was the diagnosis?

Image 56:  This was a filarial lymphangitis. Ultrasound imaging of the upper arm and cord (Toshiba Aplio machine, 12L5 megahertz set at 9 megahertz) revealed a dilated and thickened 3 mm diameter lymphatic with internal echoes consistent with mobile "dancing" filaria and/or microfilaria. The microfilaria of Wuchereria bancrofti (below) were found in his blood in small numbers. He was treated with concurrent diethylcarbamazine (14 days), albendazole (5 days) and prednisone (5 days) and the swelling slowly resolved

Quick Time video of  his dancing filaria requires latest, free, Quick Time 7 version, increase monitor brightness to increase visability
	~7 x 278 µm, sheathed, no terminal nuclei in tail