Lymphatic filariasis: Difference between revisions
(Created page with "==Background== ==Clinical Features== ==Differential Diagnosis== ==Workup== ==Management== *Diethylcarbamazine: **Day 1: 50 mg PO **Day 2: 50 mg TID **Day 3: 100 mg TID...") |
Ostermayer (talk | contribs) |
||
| (12 intermediate revisions by 4 users not shown) | |||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
*Also known as elephantiasis | |||
*Causative agents (transmitted by mosquito): | |||
**''Wuchereria bancrofti'' | |||
**''Brugia malayi'' | |||
**''Brugia timori'' | |||
*No known natural animal reservoir<ref name="Chandy">Chandy A, Thakur AS, Singh MP, Manigauha A. A review of neglected tropical diseases: filariasis. Asian Pac J Trop Med. 2011 Jul;4(7):581-6. doi: 10.1016/S1995-7645(11)60150-8.</ref> | |||
*Larvae migrate to lymphatic vessels and mature into adults (can take 6-12 months<ref name="Chandy" />) | |||
**These worms block lymphatic vessels, which causes the clinical presentation of the disease | |||
*Coinfection is common (filiariae cause immunosuppression and allows for malaria and/or TB to thrive) | |||
==Clinical Features== | ==Clinical Features== | ||
*2/3 will be asymptomatic<ref name="Taylor">Mark J Taylor, Achim Hoerauf, Moses Bockarie. Lymphatic filariasis and onchocerciasis. Lancet 2010; 376: 1175–85</ref> | |||
*Chronic infection leads to massive peripheral edema with thickening of overlying skin particularly in lower extremities and genitalia | |||
*Recurrent [[cellulitis]] is common | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
== | |||
==Evaluation== | |||
*Establish possible exposure in endemic areas | |||
*Serology (peripheral blood) - draw at night due to periodicity of filiariae | |||
*Tests for ''W. bancrofti'' | |||
**PCR | |||
**Antigen detection | |||
**Ultrasound may occasionally show movement of adult filiariae | |||
==Management== | ==Management== | ||
*Meticulous skin care to prevent superinfection/cellulitis | *Meticulous skin care to prevent superinfection/cellulitis | ||
===[[Diethylcarbamazine]] (DEC)=== | |||
{{filariasis dec treatment}} | |||
===Ivermectin + Albendazole=== | |||
*Combined treatment with diethylcarbamazine/albendazole may be more effective than single drug treatment | |||
===Surgical=== | |||
*Surgical management of scrotal elephantiasis and chronic lymphatic obstruction | *Surgical management of scrotal elephantiasis and chronic lymphatic obstruction | ||
==Disposition== | ==Disposition== | ||
*Generally may be discharged unless complicated by other factors. | |||
==See Also== | ==See Also== | ||
| Line 26: | Line 46: | ||
==External Links== | ==External Links== | ||
== | |||
==References== | |||
<references/> | <references/> | ||
[[Category:ID]] | |||
[[Category:Tropical Medicine]] | |||
Latest revision as of 13:12, 3 April 2022
Background
- Also known as elephantiasis
- Causative agents (transmitted by mosquito):
- Wuchereria bancrofti
- Brugia malayi
- Brugia timori
- No known natural animal reservoir[1]
- Larvae migrate to lymphatic vessels and mature into adults (can take 6-12 months[1])
- These worms block lymphatic vessels, which causes the clinical presentation of the disease
- Coinfection is common (filiariae cause immunosuppression and allows for malaria and/or TB to thrive)
Clinical Features
- 2/3 will be asymptomatic[2]
- Chronic infection leads to massive peripheral edema with thickening of overlying skin particularly in lower extremities and genitalia
- Recurrent cellulitis is common
Differential Diagnosis
Evaluation
- Establish possible exposure in endemic areas
- Serology (peripheral blood) - draw at night due to periodicity of filiariae
- Tests for W. bancrofti
- PCR
- Antigen detection
- Ultrasound may occasionally show movement of adult filiariae
Management
- Meticulous skin care to prevent superinfection/cellulitis
Diethylcarbamazine (DEC)
- Day 1: 50mg PO
- Day 2: 50mg TID
- Day 3: 100mg TID
- Days 4-21: 6mg/kg/day divided TID
Ivermectin + Albendazole
- Combined treatment with diethylcarbamazine/albendazole may be more effective than single drug treatment
Surgical
- Surgical management of scrotal elephantiasis and chronic lymphatic obstruction
Disposition
- Generally may be discharged unless complicated by other factors.
See Also
External Links
References
- ↑ 1.0 1.1 Chandy A, Thakur AS, Singh MP, Manigauha A. A review of neglected tropical diseases: filariasis. Asian Pac J Trop Med. 2011 Jul;4(7):581-6. doi: 10.1016/S1995-7645(11)60150-8.
- ↑ Mark J Taylor, Achim Hoerauf, Moses Bockarie. Lymphatic filariasis and onchocerciasis. Lancet 2010; 376: 1175–85