Lymphatic Filariasis Caused by Brugia timori Presenting as Lower Limbs Edema in A Pediatric Patient in Malaka Regency, East Nusa Tenggara, Indonesia

Abstract

There were 12,677 cases of LF in Indonesia, 2,864 of them were found in East Nusa Tenggara. People who suffer from LF usually have no clinical manifestation until adults. This rare case report found a pediatric case caused by LF in a 14-year-old male with marasmus. This study adopts a case study design to investigate the chronic progressive swelling of both lower extremities in a 14-year-old boy, attributing the condition to lymphatic filariasis caused by Brugia timori. Anthropometric measurements revealed Length For Age (LFA) <P₅, Weight For Age (WFA) <P₅, Ideal Body Weight (IBW) (%) 55,64%, and Upper Arm Circumference (UAC) <P₅. The physical examination showed both lower extremities have non-pitting edema, and no hydrocele was found. Through night, a blood smear with Giemsa stain examination confirmed the character of Brugia timori’s microfilaria. The patient got Diethylcarbamazine and Albendazole for two weeks. After two weeks of medical and nutritional intervention, we performed a blood smear evaluation, and no microfilaria was detected. He also gained weight of 2,8 kg after nutritional intervention. Pediatric patients rarely suffer from lower limb edema caused by LF infection. Traditional regimens 200 mg of Diethylcarbamazine (DEC) and also 400 mg of Albendazole still work for this patient. Furthermore, this new case of LF should become the government’s matter of interest to apply good policy to reach elimination status.