Aseptic knee effusion with Loa loa microfilariae in the articular fluid
Roussel, F.; Roussel, C.; Brasseur, P.; Gourmelen, O.; Le Loet, X.
Acta Cytologica 33(2): 281-283
1989
ISSN/ISBN: 0001-5547 PMID: 2929230 Document Number: 334560
A 26-year-old Cameroonian, who had lived in France for 4 years, presented with an arthritic left knee. The pain appeared during exertion the day before admission and quickly became pulsating, resulting in insomnia. At examination, the knee was moderately swollen and warm. Radiographic examination of the knees did not reveal any abnormality. The articular fluid was aseptic, devoid of microcrystals and contained many mobile microfilariae, which were identified as L. loa by the examination of Giemsa-stained smears. The patient subsequently recalled a previous history of extra-articular loiasis, which had been treated by diethylcarbamazine 13 years before, with total resolution of symptoms. He had, however, returned annually to an endemic area for holidays. His blood contained diurnal microfilariae of the same type and he had an eosinophilia of 6% of 5.4 g/litre leukocytes. Serum filarial antibody level was 1/100; erythrocyte sedimentation rate was 17 mm/h. Haemocultures were negative. Arthroscopy was not performed. The patient completely recovered in less than 3 weeks on diethylcarbamazine therapy associated with corticotherapy.