A case report of severe adverse reactions following diethylcarbamazine treatment of lymphatic filariasis

Abstract

Diethylcarbamazine (DEC) treatment for lymphatic filariasis can be accompanied by adverse drug reactions. Severe adverse reactions are usually uncommon but once happen, they could be acute and sometimes life-threatening. We report here a case of 15-year-old patient who was treated with DEC and developed severe adverse reactions including fever, headache, dizziness, chest pain, sore throat, cough, dyspnea, nausea and vomiting. A complete profile of clinical findings and blood parameters, including parasitological, hematological, biochemical, and immunological parameters was reported. The physical examination showed rhonchi on chest examination. Laboratory investigations revealed leukocytosis with the increased levels of neutrophils and monocytes. The bimodal pattern of eosinophilia was observed. However, there was no remarkable change of the biochemical parameters. We also demonstrate the magnitudes of inflammatory cytokines including interleukin 6 (IL-6) and tumor necrosis factor–α (TNF-α), and anti-inflammatory cytokine including interleukin 10 (IL-10) in the patient. This study emphasizes the need for surveillance system of adverse reactions after mass drug treatment of lymphatic filariasis control program. Moreover, the hospital admission for severe adverse reactions should been also considered.