Pictorial Urology

202 Urology Journal    Vol 7    No 3    Summer 2010

Filarial Labial Chylorrhoea
An Uncommon Problem in an Endemic Region

Urol J. 2010;7:202.
www.uj.unrc.ir

A 15-year-old girl presented with history of wetting her underwear intermittently by milky white fluid 
for the past 2 years. Initially, there were small papular lesions that subsequently transformed into milky 
fluid-filled vesicles that ruptured intermittently. Discharge increased in the evening and after prolonged 
erect posture. There was no pedal edema and her physical development was normal.

Examination revealed many 1 to 5-mm whitish-yellow papulovesiculous eruptions on both labia majora 
with thickening of the labial skin. Laboratory examination showed normal hematology, blood sugar, 
cholesterol, and creatinine. Aspirated fluid from vesicles was milky and its triglyceride level was 2.2 
mmol/L. Abdominal computed tomography scan was normal.

Patient responded to treatment by diethylcarbamazine and dietary modifications (low fat with medium 
chain triglyceride). Compression garments were worn and hypertonic saline was administered over the 
labial lesions, as previously described by our group.(1)

Filariasis has many different manifestations, including hydrocele and chyluria.(2) In secondary chylous 
reflux, lymphatic vessels become obstructed and lead to incompetent valves, resulting in reflux into the 
lower limbs and the genitalia.

Abhishek Jain, Nisar Ahmad, Apul Goel*
Department of Urology, King George Medical University, Lucknow, India

*E-mail: goelapul1@rediffmail.com

REFERENCES
1. Gupta A, Dalela D, Vasudeva P, Sankhwar SN, Goel A. Scrotal chylorrhoea: images of uncommon scrotal fluid discharge. 

Urology. 2009;73:1227-8.

2. McAleer SJ, Johnson Cw, Johnson wD. Tuberculosis and parasitic and fungal infections of the genitourinary system. In: wein 
AJ, Kavousi LR, Novick AC, Partin Aw, Peters CA, eds. Campbell-Walsh Urology. Vol 1. 9 ed: Philadelphia: w.B. Saunders; 
2007:436-70.