Southeast Asian Journal of Case Report and Review 2021;8(1):30–34 Content available at: https://www.ipinnovative.com/open-access-journals Southeast Asian Journal of Case Report and Review Journal homepage: https://www.sajcrr.com/ Case Report Chyluria: Are we doing enough for filaria elimination? Milind Ubale 1 , Debapriya Das Choudhury 1, *, Vaibhav Bari 2 , Vaibhavi Nanoty 1 1 Dept. of Microbiology, Rajiv Gandhi Medical College, Kalwa, Thane, Maharashtra, India 2 Dept. of Pathology, Rajiv Gandhi Medical College, Kalwa, Thane, Maharashtra, India ARTICLE INFO Article history: Received 12-01-2022 Accepted 14-01-2022 Available online 08-02-2022 Keywords: Filaria Chyluria ABSTRACT Filaria is known to be one of the neglected tropical disease. There are undiagnosed cases all across country due to asymptomatic nature, prolong incubation period and late manifestation of disease, ubiquitous mosquitoes and many are complacent when it comes to prevention; in part because of apathy towards the disease and pronged time it takes to manifest itself. Moreover, it is difficult to convince people to take tablet in asymptomatic stage. In this study we have reported, A 35-year-old male patient with symptoms of chronic urinary tract infection with hematuria followed by Chyluria. Microfilaria was diagnosed in laboratory investigations; treated with anti-filarial drugs. However, the chyluria was not completely cleared till the last follow up indicating to lymphovenous fistula. To make India filaria free, we do not have alternative apart from shifting Mass Drug administration program from 2 drugs (albendazole + DEC) to 3 drug (Ivermectin, DEC and albendazole) MDA strategy. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. For reprints contact: reprint@ipinnovative.com 1. Introduction Chyluria is an unusual manifestation of filariasis with milky white urine, due to passage of chyle into urine. It develops as a result of communication between the lymphatic system and the urinary system. In India, only in 2% of filariasis cases presents with this presentation. Filariasis is a parasitic disease, most commonly caused by Wuchereria bancrofti (>90% cases). transmitted by bite of Aedes, Anopheles, Culex mosquitoes. Culex quinquefasciatus is the most important vector of W. bancrofti. The Adult worms of W. bancrofti reside in lymph nodes and lymphatics. The gravid female releases microfilariae which then enter general circulation through lymphatics. The disease can be seen as classical lymphatic filariasis or occult filariasis. 1 * Corresponding author. E-mail address: Debapriya.dmr@gmail.com (D. Das Choudhury). This is a case of chronic urinary tract infection with hematuria followed by Chyluria as a presenting complaint. We also discuss here the approach to a common tropical problem of ‘white urine’ along with a review of relevant literature. 2. Case History A 35-year-old male patient, Native of Uttar Pradesh came to Maharashtra in search of job and was staying here since last 5 years. Presently he is residing in Thane slum area since last 1 1 2 years with 3 other males, working as a labourer in a private company. The patient was apparently alright 8 months back when he noticed white colour urine associated with burning micturition since 1 1 2 months. He visited a hospital following the complaints and was admitted for 10days and given symptomatic treatment including antibiotics (Tab. Nitrofurantoin). The urine became clear post treatment and he remained symptom free for almost https://doi.org/10.18231/j.sajcrr.2021.006 2319-1090/© 2021 Innovative Publication, All rights reserved. 30