"String sign"- acute lymphangitis in the forearm following triple drug therapy for bancroftian filarial infection.

Abstract

Localized adverse events following mass drug administration for lymphatic filariasis elimination are often self-limiting. However, they are of significant concern to the participants and may affect community drug compliance if not managed appropriately. Here, we report a rather uncommon adverse event, the 'string sign' in a south Indian woman with bancroftian filarial infection treated with triple drug regimen (IDA-Ivermectin, Diethylcarbamazine and Albendazole). String sign is the manifestation of acute lymphangitis as a cordlike subcutaneous swelling due to the swollen and inflamed lymphatic vessel, which is believed to occur due to the death of the adult filarial worms subsequent to chemotherapy. Health care workers need to be aware of such unusual localized adverse events that may occur following MDA for LF elimination. Prompt medical management of adverse events and health education are important to ensure adherence to drug consumption during mass drug administration program.