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 Table of Contents  
LETTER TO EDITOR
Year : 2019  |  Volume : 14  |  Issue : 4  |  Page : 434-435

Penile filariasis: Ultrasonographic evaluation


Department of Radiodiagnosis, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India

Date of Submission03-Dec-2019
Date of Decision10-Dec-2019
Date of Acceptance20-Dec-2019
Date of Web Publication16-Jul-2020

Correspondence Address:
Dr. Suresh Phatak
Department of Radiodiagnosis, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha - 442 001, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdmimsu.jdmimsu_205_19

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How to cite this article:
Shah A, Phatak S, Madurwar K, Marfani G. Penile filariasis: Ultrasonographic evaluation. J Datta Meghe Inst Med Sci Univ 2019;14:434-5

How to cite this URL:
Shah A, Phatak S, Madurwar K, Marfani G. Penile filariasis: Ultrasonographic evaluation. J Datta Meghe Inst Med Sci Univ [serial online] 2019 [cited 2020 Aug 13];14:434-5. Available from: http://www.journaldmims.com/text.asp?2019/14/4/434/289853



Sir,

Filariasis occurs in Africa, Asia, South America, The Caribbean, and The Pacific. The transmission is through mosquitoes that transmit larvae that develop into adult worms in human host.[1] Recurrent lymphangitis caused by Wuchereria bancrofti is responsible for lymphedema of the penis and penoscrotal region. The superficial lymphatics of the inguinoscrotal region drains the penile and scrotal skin; thus, obstruction of this chain by the filarial worm is probably responsible for causing this condition along with secondary interstitial edema, hypertrophy, and hyperplasia of the connective tissue, and the infiltration by inflammatory cells characterizes a chronic inflammatory process. Thickening of the cutaneous tissue and enlargement of the affected area resulting from inadequate lymphatic drainage are the clinical characteristics of such lymphedema. Involvement of the external genitalia causes a marked enlargement in volume and interferes with voiding in the standing position, movement, local hygiene, and sexual intercourse.[2]

Although diagnosis is based on the visualization of microfilaria in the blood smear, ultrasonography (USG) remains the primary imaging modality in diagnosis of penile filariasis by demonstrating filarial dance sign and lymphangiectasia.[3],[4],[5],[6],[7],[8],[9],[10],[11],[12]

We present USG finding in a case of penile filariasis. A 35-year-old man presented with complaints of painful penile swelling for 3 months, which was gradually increasing in size and pitting type [Figure 1]. He also gave a typical history of swelling which was reduced on taking medication (antifilarial treatment) and also gave a history of three other patients of filariasis in his village having lower limb involvement. The patient underwent thorough examination with particular attention to the inguinoscrotal region. USG revealed thickened penile skin showing multiple dilated lymphatic channels and mild hydrocele [Figure 2].
Figure 1: Clinical photograph of the penis and scrotum showing swollen penis and mild hydrocele

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Figure 2: Transverse and longitudinal section of the penis showing thickened soft tissues around the penis and dilated lymphatic channels within

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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.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Amaral F, Dreyer G, Figueredo-Silva J, Noroes J, Cavalcanti A, Samico SC, et al. Live adult worms detected by ultrasonography in human bancroftian filariasis. Am J Trop Med Hyg 1994;50:753-7.  Back to cited text no. 1
    
2.
Singh V, Sinha RJ, Sankhwar SN, Kumar V. Reconstructive surgery for penoscrotal filarial lymphedema: A decade of experience and follow-up. Urology 2011;77:1228-31.  Back to cited text no. 2
    
3.
Solanki R, Vaishnav KU. Radiological findings in filariasis – A case series. J Contemporary Med Res 2018;5:E1-3.  Back to cited text no. 3
    
4.
Phatak S, Marfani G. Galactocele Ultrasonography and Elastography Imaging with Pathological Correlation. J Datta Meghe Inst Med Sci Univ 2018;13:1-3. Available from: https://doi.org/10.4103/jdmimsu.jdmimsu_51_18. [Last accessed on 2019 Aug 22].  Back to cited text no. 4
    
5.
Samad S, Phatak S. Bilateral Axillary Accessory Breast with Ductal Ectasia: Ultrasonography and Elastographic Appearance. J Datta Meghe Inst Med Sci Univ 2018;13:206-8. Available from: https://doi.org/10.4103/jdmimsu.jdmimsu_54_18. [Last accessed on 2019 Aug 22].  Back to cited text no. 5
    
6.
Chaudhary KS, Phatak SV. Choroidal Melanoma in a Young Patient Ultrasonography and Magnetic Resonance Imaging. J Datta Meghe Inst Med Sci Univ 2019;14:106-8. Available from: https://doi.org/10.4103/jdmimsu.jdmimsu_48_18. [Last accessed on 2019 Aug 22].  Back to cited text no. 6
    
7.
Gulve SS, Phatak SV. Parathyroid Adenoma: Ultrasonography, Doppler, and Elastography Imaging. J Datta Meghe Inst Med Sci Univ 2019;14: 47-9. Available from: https://doi.org/10.4103/jdmimsu.jdmimsu_91_18. [Last accessed on 2019 Aug 22].  Back to cited text no. 7
    
8.
Madurwar KA, Phatak SV. Benign Fibrous Histiocytoma of Male Breast: Ultrasonography, Doppler, and Elastography Imaging with Pathological Correlation. J Datta Meghe Inst Med Sci Univ 2019;14:103-5. Available from: https://doi.org/10.4103/jdmimsu.jdmimsu_44_18. [Last accessed on 2019 Aug 22].  Back to cited text no. 8
    
9.
Phatak S, Shrivastav D, Marfani G, Daga S, Madurwar K, Samad S. Transvaginal Sonography and Elastography Evaluation of Ectopic Pregnancy. J Datta Meghe Inst Med Sci Univ 2019;14:86-9. Available from: https://doi.org/10.4103/jdmimsu.jdmimsu_13_19. [Last accessed on 2019 Aug 22].  Back to cited text no. 9
    
10.
Roy M, Gajbe UL, Singh BR, Thute P. Morphometric Measurement of Fetal Femur Length for the Prediction of Gestational Age in the Ii Nd and Iii Rd Trimester of Pregnancy by Ultrasonography. J Datta Meghe Inst Med Sci Univ 2017;12:187-90. Available from: https://doi.org/10.4103/jdmimsu.jdmimsu_71_17. [Last accessed on 2019 Aug 22].  Back to cited text no. 10
    
11.
Deshpande S, Phatak S, Marfani G, Gupta N, Daga S, Samad S. Sonographic Evaluation of Painful Shoulder and Its Comparison with Clinical Diagnosis. J Datta Meghe Inst Med Sci Univ 2018;13:12-5. Available from: https://doi.org/10.4103/jdmimsu.jdmimsu_52_18. [Last accessed on 2019 Aug 22].  Back to cited text no. 11
    
12.
Goje K, Phatak S. Testicular Torsion Causing Infarction of Testis, Ultrasonography and Color Doppler Imaging. J Datta Meghe Inst Med Sci Univ 2018;13:215-6. Available from: https://doi.org/10.4103/jdmimsu.jdmimsu_60_18. [Last accessed on 2019 Aug 22].  Back to cited text no. 12
    


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