A 68-year-old lady presented to surgery outpatient department with swelling and pain in the right submandibular region for the last 2 months. Local examination showed a soft and fluctuant swelling of 4 x 3 cm over right submandibular region. It was warm and tender on palpation. Clinical examination of the orofacial region did not revealed any odontogenic or nonodontogenic foci of infection.
All the hematological parameters were normal except for mild peripheral eosinophilia (12%) and a low hemoglobin level. A clinical diagnosis of submandibular pyogenic abscess was made and to exclude tuberculosis, FNAC was advised.
FNAC from the swelling yielded purulent material along with a creamy white thread. Smears showed adult gravid female filarial worm having an intact outer cuticle layer and body cavity filled with different stages of developing ova and microfilariae [Figure 1]. In addition, numerous embryos and coiled larvae and fully straightened larvae of W. bancrofti that were sheathed and had no nuclei in the tail end were also visualized. The background was composed of inflammatory cells including neutrophils, lymphocytes, macrophages, and eosinophils. Hence, a final diagnosis of filarial abscess was made.