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Picture of the Month

Mark L. Bagarazzi, MD; James McCarthy, MD; In K. Kim, MD; James Reynolds, MD; Thomas Nutman, MD; Barbara Watson, MD
Arch Pediatr Adolesc Med. 1997;151(5):521-522. doi:10.1001/archpedi.1997.02170420091017.
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A 16-YEAR-OLD girl from Burkina Faso (formerly Upper Volta), Africa, presented with a 7-year history of an edematous right foot (Figure 1) that worsened during a recent pregnancy. Her differential blood count showed eosinophilia. Lymphoscintigraphy was performed (Figure 2). Figure 3 presents a lymphoscintiogram with normal results for comparison.

Denouement and Discussion 

Filariasis  Bancroftian filariasis is a parasitic infection caused by the mosquito-borne filarial nematode Wuchereria bancrofti that causes various clinical manifestations including elephantiasis. Infection is prevalent throughout the tropics, with an estimated 100 million people infected and 900 million people at risk for acquiring the infection.1Adult female worms living in lymphatic vessels produce microfilariae that migrate into the bloodstream. The appearance of microfilariae in the blood generally has a periodicity, and, in most areas of the world, peaks late at night coinciding with mosquito feeding patterns. Microfilariae taken up by a mosquito during a blood meal develop


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