—Several excellent points for the clinician facing a patient ill with a disease that may be of tropical origin are made by Drs Grove and Schneider. At times it is absolutely critical to know the precise site as well as the apparent duration of exposure.
Filarial diseases often pose a diagnostic conundrum. Loiasis, bancroftian filariasis, and onchocerciasis all may provoke symptoms of eosinophilia, urticaria, and other skin involvement and may be coendemic in a region. All may exhibit lymphedema and scrotal edema, but these complaints are far more common with bancroftian filariasis. From my experience in Cameroon, I consider the clinical picture described to be more consistent with bancroftian filariasis than with these other diseases. Double infection with loiasis was a distinct possibility in the area of coendemicity in which the patient was probably infected. However, the patient would probably have recalled it had the adult loa traversed his conjunctivae,