Successful treatment of 2 imported cases of Mansonella perstans infection

About the Authors: Hilmir Asgeirsson * E-mail: hilmir.asgeirsson@sll.se Affiliations Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden, Unit of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden ORCID http://orcid.org/0000-0003-3869-8021 Andreas Harling Affiliation: Department of Infectious Diseases, Karlstad Central Hospital, Karlstad, Sweden Silvia Botero-Kleiven Affiliation: Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, SwedenCitation: Asgeirsson H, Harling A, Botero-Kleiven S (2017) Successful treatment of 2 imported cases of Mansonella perstans infection. After the discovery of the symbiotic bacteria Wolbachia in M. perstans strains from certain endemic regions, doxycycline has, however, emerged as a promising treatment alternative [11, 12]. The white blood cell count was 37.3 x 109/L, with eosinophils 24.8 x 109/L. Bone marrow biopsy revealed a cell-rich marrow with high-grade eosinophilia, without suspicion of malignancy. Filaria serology (in-house ELISA based on cross-reaction of antibodies directed against common Acanthocheilonema vitae antigens) was strongly positive (209 arbitrary units, cutoff 17), while for Strongyloides, optical density (OD) of 1.5 units (cutoff 0.5) was a suspected cross-reaction. [...]analysis revealed M. perstans 83 microfilariae/ml and Loa loa 670 microfilariae/ml peripheral blood (membrane filtration technique). [...]hypersensitivity reaction, possibly severe, with eosinophilia may be a manifestation of M. perstans infection in travelers and migrants coming from endemic areas. Key learning points * M. perstans infection commonly presents with unspecific symptoms. * M. perstans infection may present as hypersensitivity reaction, possibly severe, with eosinophilia in travelers and migrants coming from endemic areas. * Antihelminthic treatment regimens including doxycycline may be effective in clearing M. perstans...