It was the consensus of the authors that, despite the limitations inherent in the clinical, pathological and serological methods in this study, the systematic application of these methods had been of value in establishing that (1) filariasis plays an important role in the development of tropical hydrocele in Puerto Rico; (2) of 42 hydrocele patients, 24 had positive or suggestive evidence of filarial disease (59%), when all criteria were combined; (3) filarial etiology could be eliminated in 10 patients (23%) of which two had a history of trauma and the remaining eight appeared to be of the idiopathic variety; and (4) agreement between pathological and serological data was obtained in 81% of the cases, and in no case was there disagreement with the clinical data.
However, after correlating all findings there remained, besides a filarial, a traumatic, and an idiopathic group of hydroceles, 8 cases (18% of the series) in which no conclusions could be reached and in which pathological and serological data conflicted. For this reason, the incidence of filarial hydrocele in Puerto Rico has not been definitely determined in this series.
There is an evident need for further studies on the immunology and pathogenesis of filariasis, and for the development of accurate diagnostic methods for filarial disease.
Naval unit attached to the Army Tropical Research Medical Laboratory, San Juan, Puerto Rico. Present address: Naval Medical Research Institute, Bethesda 14, Maryland.
Urology Clinic, Municipal Hospital, San Juan, Puerto Rico. Present address: Brumbaugh 1104, Esq. Arzuaga, Rio Piedras, Puerto Rico.
Department of Pathology, School of Medicine, University of Puerto Rico, San Juan, Puerto Rico. Present address: Peter Bent Brigham Hospital, Boston, Massachusetts.