Serendipity in Emergency Diagnostics: Near Miss of a Loa loa Case in a Swiss Hospital.

A 31-year-old Cameroonian man presented to the emergency department (ED) with a productive cough, exertional dyspnoea, and asthenia for a few days. The initial evaluation was limited due to cultural barriers, lack of known medical history, and the patient's migration journey through Libya, Tunisia, and Germany over the past 5 years before recently arriving in Switzerland. Clinical examination revealed no red flags. Blood counts were normal, C-reactive protein (CRP) was elevated at 91 mg/L, and a chest X-ray was unremarkable. A diagnosis of influenza-like syndrome was made. The patient returned the following day with increased fatigue and fever. A rapid malaria test was negative, a blood smear was ordered, and CRP levels rose to 148 mg/L. During an influenza epidemic, PCR confirmed Influenza A. The patient was reassured and prescribed ibuprofen and paracetamol. Subsequently, the laboratory detected not malaria but filariae, and a diagnosis of Loiasis (Loa loa) was established. The patient was referred for specialist consultation. Treatment with albendazole was initiated, leading to gradual improvement.