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A 35-year-old male presented with high-grade fever, chills, rigors, headache, body ache, vomiting, and blood-mixed sputum; routine tests were normal except for eosinophilia and marked thrombocytopenia. Dengue NS1 ELISA returned positive, and subsequent peripheral blood film at midnight revealed live motile microfilariae identified as Wuchereria bancrofti. Symptomatic dengue management included platelet transfusion and diethylcarbamazine for 14 days, with follow-up midnight smears negative.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/microfilaria-a-silent-accomplice-in-a-patient-of-dengue-fever/456397/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/microfilaria-a-silent-accomplice-in-a-patient-of-dengue-fever/456397.png","ImageObject",300,407,{"name":92,"@type":93},"Danger Angel","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-05","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"How was dengue diagnosed in the patient?","Question",{"text":113,"@type":114},"Diagnosis was confirmed by a positive nonstructural protein 1 (NS1) antigen ELISA for dengue virus infection.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"When and how were microfilariae detected?",{"text":118,"@type":114},"Microfilaria were first detected on peripheral blood film examination, and a fresh sample was then collected at midnight to examine the peripheral blood film again.",{"name":120,"@type":111,"acceptedAnswer":121},"What was the treatment and outcome after follow-up?",{"text":122,"@type":114},"The patient received symptomatic dengue care including platelet transfusion, then took diethylcarbamazine 100 mg three times daily for 14 days; follow-up midnight peripheral blood film was negative for microfilariae.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},456397,1790789540,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":24,"preview_page_count":4},962090769052,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Letter to the Editor  \nMicrofilaria: A Silent Accomplice in a Patient of Dengue Fever  \nMani Bhushan Kumar1, *Nidhi Singla2, Manharpreet Kaur1, Sarabmeet Singh Lehl3, Jagdish  \nChander2  \n1Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research,  \nChandigarh, India  \n2Department of Microbiology, Government Medical College and Hospital, Chandigarh, India 3Department of Medicine, Government Medical College and Hospital, Chandigarh, India  \n*Corresponding author: Dr Nidhi Singla, [E-mail: nidhisingla76@gmail.com](E-mail: nidhisingla76@gmail.com)  \n(Received 03 Dec 2024; accepted 12 Apr 2025)  \nDear Editor  \nA 35-year-old male, driver by occupation, from Haryana (India), presented in 2018 with chief complaints of high-grade fever, chills and rigors, headache, body ache and vomiting for five days and sputum mixed with blood for one day. There was no history of swelling over the scrotum, legs, groin and hands. All routine tests were found to be within normal limits, but his eosinophil count was 9%(absolute eosinophil count: 612/μL) and his platelet count was decreased to 4000/μL. Based on symptoms, the patient was suspected of having a case of dengue virus infection. A blood sample for nonstructural protein 1 (NS1) antigen enzyme-linked immunosorbent assay for dengue virus infection was sent, which came out to be positive,  \nconfirming the diagnosis. The next day, a microfilaria was detected while examining the peripheral blood film (PBF) from the same patient. So, a fresh sample was collected at midnight and the peripheral blood film was examined. To the surprise, many live motile microfilariae (>10/wet mount) were seen, which were diagnosed to be of Wuchereria bancrofti based on typical morphology (Fig. 1).  \nThe patient was managed symptomatically with a platelet transfusion for dengue and later discharged with advice to take diethylcarbamazine 100 mg thrice a day for 14 days. The patient completed the treatment, and on follow-up, midnight PBF came out to be negative for microfilariae.  \nFig. 1. Giemsa stain (a, c) shows a sheathed microfilaria with a cephalic space (length and breadth of equal size) and a pointed tail end devoid of nuclei. Wet mount (b) shows a sheathed microfilaria, overall suggestive of Wuchereria ban  \ncrofti, India, 2018  \n183  \n[http://jad.tums.ac.ir](http://jad.tums.ac.ir)  \nPublished Online: June 30, 2025  \nCopyright © 2025 The Authors. Published by Tehran University of Medical Sciences.  \nThis work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International license ([https://creativecommons.org/licenses/by](https://creativecommons.org/licenses/by)nc/4 .0/) . Non-commercial uses of the work are permitted, provided the original work is properly cited.  \nDiscussion  \nIn tropical regions, co-infections are common, warranting strong clinical suspicion. Filariasis and arboviral infections share arthropod vectors, enabling co-infection of the vector. Concurrent infections can enhance viral transmission, a phenomenon known as ‘microfilarial enhancement of arboviral transmission ’ (1) . For viral development, the virus must cross the vector’s midgut barrier. Microfilariae help breach this barrier, allowing viral entry into the hemocoel, accelerating replication and transmission. Viruses may also attach to microfilaria, which act as physical carriers across the midgut (2) . Co-infection with dengue and filariasis creates a complex clinical challenge requiring careful management. Filariasis, a neglected tropical disease affecting over 120 million people globally, often remains asymptomatic despite residing in and damaging the lymphatic system (3) . India carries about 40% of the global lymphatic filariasis burden (2) . In our case, microfilaria was incidentally detected on a peripheral smear. The patient likely had chronic filariasis and acquired a superimposed dengue infection during the mosquito breeding season. The WHO's Global Program to Eliminate Lympha","cbCaiqyhUvxyrx6N","https://ap.wps.com/l/cbCaiqyhUvxyrx6N","pdf",568593,"English","# Letter to the Editor\n## Discussion\n## Conclusion\n## Conflict of interest statement\n## References","[{\"question\":\"How was dengue diagnosed in the patient?\",\"answer\":\"Diagnosis was confirmed by a positive nonstructural protein 1 (NS1) antigen ELISA for dengue virus infection.\"},{\"question\":\"When and how were microfilariae detected?\",\"answer\":\"Microfilaria were first detected on peripheral blood film examination, and a fresh sample was then collected at midnight to examine the peripheral blood film again.\"},{\"question\":\"What was the treatment and outcome after follow-up?\",\"answer\":\"The patient received symptomatic dengue care including platelet transfusion, then took diethylcarbamazine 100 mg three times daily for 14 days; follow-up midnight peripheral blood film was negative for microfilariae.\"}]","Microfilaria: A Silent Accomplice in a Patient of Dengue Fever | PDF",1790745935]