Dracunculiasis
Background
- Also known as Guinea Worm disease
- Caused by Dracunculus medinensis - infection due to drinking contaminated water
- Generally limited to central Africa
- Effort underway to eradicate disease in endemic countries[1]
Helminth infections
Cestodes (Tapeworms)
- Taenia saginata
- Taenia solium (Cysticercosis)
- Diphyllobothrium latum
- Hymenolepis nana
- Echinococcus granulosus
Trematodes (Flukes)
- Fasciola hepatica
- Fasciolopsis buski
- Opistorchis viverrini
- Schistosoma spp
- Chlonorchis sinensis
- Paragonimus spp.
Nematodes (Roundworms)
- Ascaris lumbricoides
- Enterobius vermicularis (Pinworm)
- Filarial worms
- Hookworm
- Necator americanus
- Ancylostoma duodenale
- Cutaneous larva migrans (Ancylostoma braziliense)
- Dracunculiasis
- Strongyloides stercoralis
- Trichuris trichiura (Whipworm)
- Anisakis
- Toxocara spp.
- Trichinosis
Clinical Features
- Adult worm migrates through subcutaneous tissues of the leg and erodes through skin, approximately 1 year after infection[1]
- Symptoms prior to eruption include: rash, intense pruritus, nausea/vomiting, dyspnea, and diarrhea
Differential Diagnosis
- Papules
- Insect bites
- Scabies
- Seabather's eruption
- Cercarial dermatitis (Swimmer's Itch)
- Macular
- Sub Q Swelling and Nodules
- Ulcers
- Tropical pyoderma
- Leishmaniasis
- Mycobacterium marinum
- Buruli ulcer
- Dracunculiasis (Guinea Worm disease)
- Linear and Migratory Lesions
- Cutaneous larvae migrans
- Photodermatitis
See also domestic U.S. ectoparasites
Evaluation
- Clinical diagnosis
Management
- Metronidazole 750mg TID x 5-10 days OR thiabendazole 50-75mg/day divided BID x 3 days
- Must also extract adult worm from skin
- Patients with active skin lesions should avoid contact with potable water
Disposition
- Discharge