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Section 3. Summaries of Infectious Diseases
Lymphatic Filariasis
(Bancroftian, Malayan, and Timorian)
Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures
CLINICAL MANIFESTATIONS: Most filarial infections are asymptomatic.
Even in asymptomatic people, adult filarial worms commonly cause
subclinical lymphatic dilatation and dysfunction. Lymphadenopathy
is the most common clinical sign of lymphatic filariasis in
children, most frequently of the inguinal, crural, and epitrochlear
lymph nodes, in association with living adult worms. Death of
the adult worm triggers an acute inflammatory response, which
progresses distally (retrograde) along the affected lymphatic
vessel, usually in the limbs. If present, systemic symptoms,
such as headache or fever, usually are mild. In postpubertal
males, adult
Wuchereria bancrofti organisms are found most commonly
in the intrascrotal lymphatic vessels; thus, inflammation resulting
from adult worm death may present as funiculitis, epididymitis,
or orchitis. A tender granulomatous nodule is palpable at the
site of the dead adult worms. The chronic manifestations of
lymphedema and hydrocele rarely occur in children. Recurrent
secondary bacterial infections hasten the progression of lymphedema
to its advanced stage, known as elephantiasis. Chyluria can
occur as a manifestation of bancroftian filariasis. Cough, fever,
marked eosinophilia, and high serum immunoglobulin E concentrations
are manifestations of the tropical pulmonary eosinophilia syndrome.
ETIOLOGY: Filariasis is caused by 3 filarial nematodes:
Wuchereria bancrofti, Brugia malayi, and
Brugia timori.
EPIDEMIOLOGY: The parasite is transmitted by the bite of infected
species of various genera of mosquitoes, including
Culex, Aedes, Anopheles, and
Mansonia. Wuchereria bancrofti is found in Haiti,
the Dominican Republic, Guyana, Brazil, sub-Saharan and North
Africa, and Asia, extending into a broad zone from India through
the Indonesian archipelago into Oceania. Humans are
. . . [Go to Full Text]
Related text in Red Book:
- Drugs for Parasitic Infections
Red Book
2006: 790-820.
[Extract]
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