Filariasis of the axilla in a patient returning from travel abroad: a case report.
BACKGROUND
The term filariasis comprises a group of parasitic infections caused by helminths belonging to different genera in the superfamily Filaroidea. The human parasites occur mainly in tropical and subtropical regions, but filariae are also found in temperate climates, where they can infect wild and domestic animals. Humans are rarely infected by these zoonotic parasites.


METHODS
A 55-year-old patient presented with a new-onset, subcutaneous, non-tender palpable mass in the right axilla. Ultrasonography showed a 1.3-cm, solid, singular encapsulated node. Sonography of the breast on both sides, axilla and lymphatic drainage on the left side, lymphatic drainage on the right side, and mammography on both sides were without pathological findings. The node was excised under local anesthesia as the patient refused minimal invasive biopsy.


RESULTS
On histopathological examination, the tail of a parasite of the group of filariae was found. The patient revealed that she had stayed in Africa and Malaysia for professional reasons. 6 months before the time of diagnosis, she had also suffered from a fever and poor general condition after a trip abroad. The patient was referred for further treatment to the Institute for Tropical Medicine at the University of Dusseldorf, where a treatment with ivermectin was conducted on the basis of positive staining with antibodies against filariae.


CONCLUSIONS
Our case demonstrates the importance of interdisciplinary collaboration between breast center, pathology, and other specialties such as microbiology and tropical medicine.
Department of Obstetrics and Gynecology, University Hospital of Cologne, Germany ; CIO Cologne-Bonn, Breast Center, Ludwig Maximilian's University Munich, Germany.
Maria
M
Roethlisberger
University Hospital of Munich, Breast Center, Ludwig Maximilian's University Munich, Germany ; University Hospital of Munich, Comprehensive Cancer Center, Ludwig Maximilian's University Munich, Germany.
Rachel
R
Wuerstlein
CIO Cologne-Bonn, Breast Center, Ludwig Maximilian's University Munich, Germany ; Department of Pathology, University Hospital of Bonn, Germany.
Michael
M
Majores
Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital of Dusseldorf, Germany.
Irene
I
Müller-Stöver
Department of Microbiology, University Hospital of Bonn, Germany.
Hanns M
HM
Seitz
Department of Obstetrics and Gynecology, University Hospital of Cologne, Germany ; CIO Cologne-Bonn, Breast Center, Ludwig Maximilian's University Munich, Germany.
Kerstin
K
Rhiem
Department of Obstetrics and Gynecology, University Hospital of Cologne, Germany ; CIO Cologne-Bonn, Breast Center, Ludwig Maximilian's University Munich, Germany.
Stefan
S
Kraemer
Department of Obstetrics and Gynecology, University Hospital of Cologne, Germany ; CIO Cologne-Bonn, Breast Center, Ludwig Maximilian's University Munich, Germany.
Peter
P
Mallmann
CIO Cologne-Bonn, Breast Center, Ludwig Maximilian's University Munich, Germany ; Department of Pathology, University Hospital of Cologne, Germany.
Reinhard
R
Büttner
University Hospital of Munich, Breast Center, Ludwig Maximilian's University Munich, Germany ; University Hospital of Munich, Comprehensive Cancer Center, Ludwig Maximilian's University Munich, Germany.
Nadia
N
Harbeck
Axilla; Breast; Filariasis