Case Report
Filariasis of Stensen’s Duct: An Index Case
Eishaan K. Bhargava,
1
Nikhil Arora,
1
Varun Rai,
1
Ravi Meher,
1
Prerna Arora,
2
and Ruchika Juneja
1
1
Department of Ent and Head and Neck Surgery, Maulana Azad Medical College, New Delhi, India
2
Department of Pathology, Maulana Azad Medical College, New Delhi, India
Correspondence should be addressed to Nikhil Arora; for nikhilarora@yahoo.com
Received 23 July 2016; Accepted 13 October 2016
Academic Editor: Nicolas Perez-Fernandez
Copyright © 2016 Eishaan K. Bhargava et al. Tis is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Filariasis, a neglected tropical disease, is a global health problem and is endemic to 73 countries including India. It is caused by nema-
todes of Filariodidea family, namely, W. bancrofi and B. malayi in India, which have a predilection for the lower limbs and testis. We
report a never before reported case of flariasis of the main parotid duct in a 25-year-old male that resolved on medical management,
exemplifying the importance of maintaining a high index of suspicion and careful examination of cytological smears in endemic
countries, allowing for an early diagnosis and treatment, decreasing the morbidity of this debilitating disease.
1. Introduction
Filariasis, a neglected tropical disease, is a global health prob-
lem afecting 73 countries, including India, with a population
of over 1.2 billion at risk for infection [1]. It is caused by
infection with nematodes of the family Filariodidea, namely,
Wuchereria bancrofi (90% cases), Brugia malayi (majority
of remainder cases), and B. timori (rare), of which the
former two are found in India. Although these parasites
have a marked predilection for lower limb lymphatics, the
epididymis, and the spermatic cord [2], they have also been
reported to occur at unusual sites such as the thyroid gland
[3], body fuids [4], skin [5], breast [6], and the oral or perioral
region [7]. Salivary gland involvement is very rare and has
been reported only once previously [8]. Here, we report a
previously unreported case of flariasis of the parotid duct in
a young adult male.
2. Case Report
A 25-year-old man, resident of Uttar Pradesh, presented
to the otorhinolaryngology outpatient department with a
painless swelling of the lef cheek, gradually increasing in
size since he frst noticed it 1 year earlier. He gave a history
of temporary increase in size of the swelling while eating,
with subsequent return to previous size on completion of
a meal. On examination, a 2 cm × 1.5 cm globular swelling
was present just below the lef malar prominence, which, on
palpation, was nontender, euthermic, frm, and mobile in all
directions with no fxity to skin or underlying tissues and
a grossly normal overlying skin. Te swelling increased in
prominence when the patient was made to clench his teeth.
He was afebrile, with no lymphadenopathy or organomegaly.
His complete blood counts revealed absolute eosinophilia
(1100/mm
3
), with an essentially normal peripheral smear.
On ultrasonography, a cystic dilatation of the middle part
of the lef Stensen’s duct was seen with minimal lobulated sof
tissue contents and a mildly thickened duct wall. A contrast
enhanced computed tomography scan was done that showed
a small, well defned, hypodense cystic lesion superfcial to
the anterolateral aspect of the lef masseter muscle indenting
its surface, communicating with a tubular hypodense struc-
ture communicating with the parotid gland, suggestive of a
dilated Stensen’s duct with a sialocele formation (Figures 1(a)
and 1(b)).
Afer clinical and radiological examination, the diferen-
tial diagnosis that came to our mind was that it is either a
sialolith blocking the duct that has lead to the infammatory
swelling or cysticercosis but further investigations showed a
diagnosis which was very diferent and rare.
Hindawi Publishing Corporation
Case Reports in Otolaryngology
Volume 2016, Article ID 7646451, 3 pages
http://dx.doi.org/10.1155/2016/7646451