Presented here is a 21 years old female who presented with progressive unilateral vulvar swelling over a period of two years. Microfilariae were found in peripheral blood film. The diagnosis of vulvar filarial elephantiasis was reached. [ajol.info]

Presentation of the case A 65-year-old man presented in Beira Central Hospital, Mozambique, with a right scrotal mass (diameter 80 x 80 cm), evolved over 15 years. [journals.plos.org]

Case Presentation An 18-year-old, unmarried female presented with the complaint of low grade fever on and off and a perineal swelling. The swelling had been present for 2 years, slowly increasing to its present size. [ncbi.nlm.nih.gov]

At the time of presentation, she was being treated with bosentan and sildenafil for pulmonary arterial hypertension, in addition to prednisone, venlafaxine, lansoprazole, metoclopramide, levothyroxine, temazepam, aspirin, and oxycodone. [mdedge.com]

Therefore, we present a case of ENV in a 74-year-old man who had congestive heart failure, diabetic nephropathy, and obesity. [cfp.ca]

• Inflammation

  ABCDE Assessment and would require different methods (including surgery) to reduce swelling Swelling Inflammation and complications. Last updated: Sep 19, 2022 [lecturio.com]

  This causes inflammation at the site of infection, leading to further recruitment of inflammatory mediators and localized clotting. Inflammation throughout the limb leads to the swelling. [bio.davidson.edu]

  Donovanosis also gives rise to genital elephantiasis because the body’s immune response to the infection of the bacterium causes inflammation and constriction of the lymphatic vessels. [xpertdox.com]

  Although elephantiasis nostras verrucosa is striking in clinical appearance, biopsy reveals only moderately abnormal findings: pseudoepitheliomatous hyperplasia with dilated lymphatic spaces in the dermis, accompanied by chronic inflammation and fibroblast [ncbi.nlm.nih.gov]

  Acute lymphangitis (inflammation of the lymphatic vessels) or lymphadenitis (inflammation of the lymph nodes) can sometimes occur with inflammation of the skin, fever, headache, backache, and nausea. [hoool.com]

• Asymptomatic

  Symptoms According to the World Health Organization, there are three conditions of lymphatic filariasis: asymptomatic, acute, and chronic. Most infections are asymptomatic. [vestergaard.com]

  The vast majority of infected people are asymptomatic, but virtually all of them suffer from damages to the lymphatic system and the kidneys, and from an altered body's immune system. [who.int]

  Three stages of infection follow: incubation or asymptomatic phase acute inflammatory phase obstructive phase. [qm.qld.gov.au]

  In fact, most lymphatic filariasis is asymptomatic without producing any external signs, although damage to the lymphatic system, kidneys, and immune system is occurring. [hoool.com]

• Chills

  Fever is commonly associated with chills, rigors, sweating, and flushing of the skin. [lecturio.com]

  Acute attack is usually associated with local pain and swelling and with fever and chills. Lymphoedema and its more advanced form, elephantiasis, occur primarily in the lower limbs and are commoner in women. [who.int]

  People with symptoms of muscle thickening and stiffening along with chills and fever must consult a doctor and get the necessary physical tests done. [lybrate.com]

  The body's allergic reactions may include repeated episodes of fever, shaking chills, sweating, headaches, vomiting, and pain. [medical-dictionary.thefreedictionary.com]

  Constitutional symptoms may also be present in the form of fever, chills, and a general feeling of ill health (malaise). The disease may also affect the external genital organs. In a male, enlargement of the scrotum can be found. [xpertdox.com]

• Lymphadenopathy

  The commonest cause in some parts of the world is filariasis, but in others it is probably tuberculous lymphadenopathy, followed by chronic pyogenic infection: the latter two may occur together. [isradiology.org]

  ChronicAcute 1- enlargment of upper limb or lower limb or genital organs and became solid. 2- hydrocoele fluid. 3- hepatomegally 4- splenomegaly 5- in rere case the patient will deid. 1- fever. 2- inguinal pain. 3- sweating 4- headache. 5- nausea. 6- lymphadenopathy [slideshare.net]

  […] by fever without associated adenitis Tropical pulmonary eosinophilia (TPE) Acute ADL This refers to the sudden onset of febrile, painful lymphadenopathy. [flipper.diff.org]

  On general physical examination, the patient was afebrile and there was no lymphadenopathy. Local examination revealed a polypoidal growth measuring 5 × 6 cm, arising from the left labium minus. [ncbi.nlm.nih.gov]

• Recurrent Infection

  infections (3.1%), podoconiosis (1.8%), tuberculosis (1.0%), malignancy (1.3%), Kaposi's sarcoma (1.0%), leishmaniasis (0.2%), and neurofibromatosis (0.2%). [ncbi.nlm.nih.gov]

  Protein-rich fluid accumulation and recurrent infection cause ENV, resulting in a vicious cycle. Early diagnosis and treatment can reduce the morbidity and mortality of ENV. [cfp.ca]

  Google Scholar Recurrent infection leads to obstruction of the lymphatic channels by fibrosis. Impaired lymphatic drainage causes the accumulation of lymphatic fluid, stimulating additional fibrogenesis. [goldjournal.net]

• Dyspnea

  He also complained of worsening dyspnea on exertion. His medical history was relevant for congestive heart failure, type 2 diabetes mellitus with nephropathy, and morbid obesity (body mass index 40.4 kg/m2). [cfp.ca]

  He also described worsening dyspnea on exertion and 3-pillow orthopnea. His medical history was significant for poorly controlled congestive heart failure (CHF); obesity (body mass index, 43 kg/m2); atrial fibrillation; and diabetes mellitus. [jabfm.org]

  Presenting symptoms include a dry, paroxysmal cough; wheezing; dyspnea; anorexia; malaise; and weight loss. Symptoms of TPE are usually due to the inflammatory response to the infection. [flipper.diff.org]

• Hypotension

  Complications reported include fever, chills, some hemodynamic changes including changes to systolic blood pressure with no frank hypotension.[17] Consultations Lymphatic filariasis is rare in the United States. [ncbi.nlm.nih.gov]

• Arthritis

  Complications Occult filariasis - infection of other tissues without evidence in blood.[6] It can lead to: Tropical pulmonary eosinophilia Filarial arthritis Filarial-associated immune complex glomerulonephritis Filarial breast abscesses Loiasis - co-endemic [ncbi.nlm.nih.gov]

  The subcutaneous worms present with skin rashes, urticarial papules, and arthritis, as well as hyper, and hypopigmentation macules. [flipper.diff.org]

  […] who develop the chronic stages of elephantiasis are usually amicrofilaraemic and often have adverse immunological reactions to the microfilariae as well as the adult worms. [10] The subcutaneous worms present with skin rashes, urticarial papules, and arthritis [en.wikipedia.org]

  […] immitis or D repens infection - Human infection with D immitis may result in pulmonary lesions of immature Dirofilaria worms in the lung periphery; if D immitis larvae lodge in branches of the pulmonary arteries, they can cause pulmonary infarcts Filarial arthritis [emedicine.medscape.com]

• Skin Disease

  This case report illustrated a rare and non-reversible complication of a common skin disease, lymphoedema and also the importance of identifying and treating it early. [ncbi.nlm.nih.gov]

  It was started in 1999 as a not-for-profit venture to provide effective treatment for skin diseases. [iad.org.in]

  The disease is difficult to detect early. Improved treatment and laboratory tests are needed. A vaccine is not yet available. Also see Lymphatic filariasis. SLIDESHOW Rosacea, Acne, Shingles, Covid-19 Rashes: Common Adult Skin Diseases See Slideshow [medicinenet.com]

  The Nuttall Encyclopedia (0.00 / 0 votes) Rate this definition: Elephantiasis a peculiar skin disease, accompanied with abnormal swelling; so called because the skin becomes hard and stiff like an elephant's hide; attacks the lower limbs and scrotum; [definitions.net]

  The word is still used in the medical field for various infectious skin diseases in which the affected part becomes grossly enlarged. [merriam-webster.com]

• Skin Edema

  Edema of the limbs is graded on the severity of the edema Grade I – Pitting (after pressing the edematous limb with the finger tip for 30 seconds, the fluid gets displaced into the surrounding tissue and leaves a ‘depression’ in the skin) edema which [pediatriconcall.com]

• Skin Fissure

  The skin over the affected areas becomes thick and rough. Cracks in the skin (fissures) begin to form and bacterial skin infections set in thereby presenting with localized tenderness, pain, heat and at times pus discharge. [healthhype.com]

• Encephalopathy

  It can cause severe drug interactions including encephalopathy if treated with ivermectin.[16] Adverse effects after receiving targeted medical therapy are likely related to systemic inflammation from filarial activity. [ncbi.nlm.nih.gov]

  DEC can worsen Onchocerciasis (an eye disease caused by Onchocerca volvulus ) and can cause encephalopathy (brain disease) and death in people who are infected with Loa loa. [parasitesinhumans.org]

  In patients with loiasis, DEC can cause serious adverse reactions, including encephalopathy and death. The risk and severity of the adverse reactions are related to Loa loa microfilarial density. [healthjade.com]

• Swelling of the Scrotum

  Definitions of elephantiasis 1 n hypertrophy of certain body parts (usually legs and scrotum); the end state of the disease filariasis Types: elephantiasis neuromatosa hypertrophy of a limb chyloderma, elephantiasis scroti swelling of the scrotum resulting [vocabulary.com]

  Elephantiasis severely disrupts this delicate balance and can cause devastating and painful manifestations including severe swelling of the arm, leg, breast or vulva (in women) and swelling of the scrotum and penis (in men). [sabin.org]

  In men, elephantiasis can also result in the swelling of the scrotum (hydrocele). Elephantiasis affects the poorest communities, preventing individuals from living a productive working and social life, further trapping them in the cycle of poverty. [unitingtocombatntds.org]

  People with the disease can suffer from lymphedema and elephantiasis and in men, swelling of the scrotum, called hydrocele. Lymphatic filariasis is a leading cause of permanent disability worldwide. [cdc.gov]

• Testicular Mass

  Chronic infection can lead to swelling of the extremities, hydroceles, and testicular masses.[1][2][3] It is the second-largest cause of permanent deformity and disability behind leprosy worldwide. [ncbi.nlm.nih.gov]

The histopathological diagnosis was suggested as vulval elephantiasis, and further workup was suggested. Subsequent to histopathologic report, filarial antigen serology was done, which was positive. [ncbi.nlm.nih.gov]

[…] affecting humans and animals, caused by filariae; ie, nematode parasites of the family Filariidae. [1] Filarial parasites can be classified according to the habitat of the adult worms in the vertebral host, as follows (see Pathophysiology, Etiology, and Workup [emedicine.medscape.com]

• Wuchereria Bancrofti

  Wuchereria bancrofti Footnotes: Figure A: Microfilaria of Wuchereria bancrofti with sheath at the posterior end in a thick blood smear stained with Giemsa. Figure B: Microfilaria of Wuchereria bancrofti in a thick blood smear stained with Giemsa. [healthjade.com]

  They are Wuchereria bancrofti, Brugia malayi, and Brugia timori. They typically occupy the lymphatic system of the definitive host. [biology-online.org]

  Lymphatic filariasis is a parasitic disease caused by thread-like worms called Wuchereria bancrofti. [parasitesinhumans.org]

• Brugia Malayi

  They are Wuchereria bancrofti, Brugia malayi, and Brugia timori. They typically occupy the lymphatic system of the definitive host. [biology-online.org]

  In Asia, the disease can also be caused by Brugia malayi and Brugia timori. The infection spreads from person to person by mosquito bites. [healthjade.com]

  Lymphatic filariasis is caused by the parasites Wuchereria bancrofti, Brugia malayi, and Brugia timori, which live in the lymphatic system. [news-medical.net]

  The disease causing parasitic worms are of three types (Wuchereria bancrofti, Brugia malayi, and Brugia timori) and are spread by the bites of infected mosquitoes. [xpertdox.com]

CDC gives the physicians the choice between 1 or 12-day treatment of DEC (6 mg/kg/day). One day treatment is generally as effective as the 12-day regimen. [healthjade.com]

Additional recommended knowledge Contents 1 Causes 2 Treatment 2.1 Antibiotics as a possible treatment 2.2 Genome deciphered Causes Elephantiasis generally results from obstructions of the lymphatic vessels. [bionity.com]

Management : Treatment of elephantiasis usually involves treatment of the underlying condition. Treatment strategy considerably differs depending on the geographic location of the endemic area. [xpertdox.com]

As of 2015, a total of 6.2 billion treatments delivered to over 820 million people. [ncbi.nlm.nih.gov]

“Some individuals develop AEs after treatment, and this can reduce the willingness of persons in endemic areas to accept treatment,” the authors wrote. “The purpose of this study was to improve understanding of the cause of AEs following treatment. [genengnews.com]

Prognosis Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Non-Hodgkin Lymphomas is good with early diagnosis and intervention. [lecturio.com]

The prognosis for Lymphatic Filariasis is generally good, as most individuals are asymptomatic. [dovemed.com]

Prognosis With DEC treatment, the prognosis is good for early and mild cases of lymphatic filariasis. The prognosis is poor, however, for heavy parasitic infestations. [hbmdistribution.com]

To describe the clinical and pathologic characteristics and etiologic factors of localized lymphedema. [ncbi.nlm.nih.gov]

The clinical history, absence of other etiologies, and treatment response suggested this represented a late complication of C. trachomatis infection. [goldjournal.net]

Infectious etiologies of genital elephantiasis outside of filariasis endemic regions: a case report. [afju.springeropen.com]

Both etiologies of elephantiasis, LF and podoconiosis, are geographically overlapped in Jeldu district. 1. [hindawi.com]

However, other disorders cause tropical lymphedema, and this report aims to identify clinical epidemiological aspects of limb swelling in northern Ethiopia and to provide an algorithm orienting the clinical diagnosis. [ncbi.nlm.nih.gov]

Filariasis: Epidemiology, 2013. http://www.who.int/lymphatic_filariasis/epidemiology/en/ > 4 Biology - Life Cycle of Wuchereria bancrofti, 2010. http://www.cdc.gov/parasites/lymphaticfilariasis/biology_w_bancrofti.html > 5 Parasites - Lymphatic Filariasis [microbewiki.kenyon.edu]

Trop Med Int Health. 2001 Aug;6(8):582-606 epidemiology life cycle pathology clinical features investigations treatment prevention and control [gpnotebook.com]

References To the Editor: Elephantiasis nostras verrucosa (ENV) is a skin disorder caused by marked underlying lymphedema that leads to hyperkeratosis, papillomatosis, and verrucous growths on the epidermis.1 The pathophysiology of ENV relates to noninfectious [mdedge.com]

‘However, there are differences in the epidemiology and pathophysiology of elephantiasis and hydrocele.’ ‘During the past four years, 80 million people have been successfully treated for elephantiasis, one of the world's most disfiguring diseases.’ [oxforddictionaries.com]

‘However, there are differences in the epidemiology and pathophysiology of elephantiasis and hydrocele.’ [en.oxforddictionaries.com]

Pathophysiology The pathophysiology is permanent lymphatic dilatation and dysfunction. This leads to swelling and secondary infections resulting in chronic skin changes and continued risk of infection. [dermatologyadvisor.com]

Large-scale treatment (preventive chemotherapy) Elimination of lymphatic filariasis is possible by stopping the spread of the infection through preventive chemotherapy. [who.int]

Podoconiosis is unique in being an entirely preventable non-communicable disease. [ncbi.nlm.nih.gov]

If people have these drugs, the disease can be prevented,” said Dr. Japtap. However, he said, it is a challenge to convince people to take them because very few understand the concept of prevention. [thehindu.com]

Prevention and Treatment Prevention Since there is no known vaccine or cure for lymphatic filariasis, the most effective method that exists to control the disease is prevention. [web.stanford.edu]