Question

In a patient presented with a fever and a positive filarial antigen test, what is the next appropriate method of management?

• A. Bone marrow biopsy
• B. DEC provocation test
• C. Detection of microfilariae in the blood smear
• D. Ultrasound of the scrotum

Answer 1

The Correct Option is C

In a patient presenting with fever and a positive filarial antigen test, the next appropriate step in management is to detect microfilariae in a blood smear. This diagnostic test confirms the presence of the parasitic worms responsible for filariasis. Here's how it fits into the clinical approach:

1. Understand that the positive antigen test suggests a filarial infection, but further evidence is needed to guide treatment.
2. Detection of microfilariae in the blood, typically done by examining a thick blood smear under a microscope, is crucial. This method visualizes the larval stage of the parasite.
3. Blood smears are often taken at night because microfilariae exhibit nocturnal periodicity, meaning they are more abundant in the peripheral blood during nighttime.
4. Once microfilariae are identified, specific treatments targeting the parasitic infection can be administered.

Thus, confirming the diagnosis with a blood smear complements the initial antigen test and helps direct appropriate antiparasitic therapy. Other options such as a bone marrow biopsy, DEC provocation test, and ultrasound of the scrotum are not suitable for confirming filariasis diagnosis.