OCCULT FILARIA INFECTION: COULD IT BE A CAUSE OF CHRONIC DRY COUGH?

Background: Management of chronic dry cough is a challenging problem for physicians. A significant proportion of patients remain undiagnosed and not cured for a long period. So this study was undertaken to identify etiology of chronic dry cough. Methods: A prospective study was done in a private center, Dhaka during the period of April 2007-February, 2008 among 80 patients who were suffering from chronic dry cough for more than three months. Results: 80 patients of chronic dry cough were prospectively studied on the basis of history, clinical examination and investigation reports. Among them, (41, 51.25%) were diagnosed as having usual causes of dry cough like cough variant asthma (21, 26.25%), heart Failure (10, 12.5%), sinusitis/post nasal drip (4.5%), gastro esophageal reflux disease (2, 2.5%) and drug- ACE inhibitor (4,5%). This group of patients improved after treatment of their primary cause except 6 (7.5%), who showed no improvement. These patients and the rest 39 (48.75%) patients did not have any discernible cause of chronic cough. They were evaluated by CFT for filaria. Among them, 20 cases (25%) showed moderate to strongly positive result. This CFT filaria positive group was treated with a combination of ivermectin and albendazole. Patients were followed up for up to four months. Result showed cough was totally absent in 80% treated patients with the rest 20% showing significant improvement. Conclusion: This study advocates that, significant proportion of chronic dry cough patients were actually suffering from occult filaria and they responded well to treatment with drugsivermectin and albendazole combination.   doi:10.3329/jom.v10i1.1994 J Medicine 2009; 10: 3-6