filariasis (wucheresiasis)

Introduction

Infection of the lymphatic system with Filaria:

• Wuchereria bancrofti
• Brugia malayi
• Brugia timori

Epidemiology

• mosquito-borne infection
• Culex fatigans
• Anopheles mosquitoe
• Aedes mosquitoe

Pathology

• larvae produces inflammation & later scarring, lymphatic obstruction & lymphedema

Clinical manifestations

• headache
• photophobia
• vertigo
• fatigue
• low-grade fever
• myalgia
• conjunctivitis
• orchitis
• lymphangitis
• lymphadenopathy (acutely)
• obstruction of lymphatic & venous drainage with edema
• hydrocele
• elephantiasis
  • breasts
  • scrotum
  • vulva
  • legs

Laboratory

• microfilariae in stained blood smears
• complement fixation may be positive
• complete blood count: eosinophilia
• Filaria antigen in serum
• Filaria antibody in serum

Differential diagnosis

• other causes of elephantiasis

Management

• antihelmintics
  • diethylcarbamazine 6 mg/kg or 200 mg PO QD for 2-3 weeks
  • ivermectin 150-200 ug/kg single dose
• Herxheimer-like reaction secondary to dying off of filaria

More general terms

• helminth infection

Additional terms

• Brugia malayi
• Brugia timori
• Wuchereria bancrofti