Paroxysmal Inflammatory Filariasis

Human filarial infections, widely prevalent worldwide,1may be imported into the United States from tropical and subtropical locales by travelers2,3or immigrants, including those in recent influxes from Indochina, Cuba, and Haiti.1,4Infections caused by lymphatic dwelling filariae (eg,Wuchereria bancrofti, Brugia malayi, andBrugia timori) can produce a wide range of clinical manifestations.5These infections may be asymptomatic, despite microfilariae in the bloodstream, or they can result in tropical pulmonary eosinophilia6or manifestations due to lymphatic obstruction such as hydrocele formation or elephantiasis. In addition, filarial infections may cause an enigmatic inflammatory entity calledfilarial fevers, or paroxysmal inflammatory filariasis, characterized by recurrent episodes of fever, lymphadenitis, and lymphangitis. Outside of filarial endemic areas in which it is common, paroxysmal inflammatory filariasis may not be readily diagnosed because the apparent lack of specificity of the symptom complex and the self-limited, although recurrent, nature of