Presentation
Microfilaremia was present in 90% and Calabar swellings in only 16% of the endemic patients. Conversely, only 10% of the expatriates were microfilaremic while 95% complained of Calabar swellings. [ncbi.nlm.nih.gov]
She presented to the emergency department with complaints of foreign body sensation, irritation, and described the feeling of something moving in the left eye. [eyetube.net]
Entire Body System
- Fatigue
Generalized itching, hives, muscle pains, arthralgias, fatigue, and adult worms visibly migrating under the surface of the skin may be observed. [orpha.net]
Less common are symptoms of itching over the entire body, muscular and joint pain as well as fatigue. [cntd.lstmed.ac.uk]
- Fever
Treatment with microfilariacides may cause massive death of microfilariae and provoke fever, meningoencephalitis, nephritis, coma and death. [histopathology-india.net]
Symptoms described were fever, pruritus, headache, arthralgia. Most symptoms appeared 24 to 36 hours after treatment. Temperature increased significantly in group 3. [ncbi.nlm.nih.gov]
There may also be fever, muscle or joint pain, weight loss and lymphadenitis. Rash sometimes lasts for several months after treatment. [patient.info]
[…] and elephantiasis of the legs, arms, scrotum, vulva, and breasts The following acute syndromes have been described in lymphatic filariasis: Acute adenolymphangitis (ADL) - Sudden fever with lymphadenopathy Filarial fever - Fever without associated adenitis [emedicine.com]
R R Hospital, Tirupati with history of pain and foreign body sensation in the left eye, fever, urticarial rash, painless swellings on the ankles, feet and fingers, painless creeping sensation of a worm from the left shoulder, of 1 week duration He had [ijo.in]
- Anorexia
Within 12–24 hours post-Ivermectin treatment (D1), individuals complained of fatigue, anorexia, and headache, joint and lumbar pain—a bent forward walk was characteristic during this initial stage accompanied by fever. [en.wikipedia.org]
Respiratoric
- Aspiration
Trypanosomes were isolated from a lymph node aspirate only after repetition of the procedure 2 months later and the patient was treated with suramin. [ncbi.nlm.nih.gov]
- Orthopnea
[…] infection (UTI) excluded from analysis; 1 female patient excluded from analysis as was menstruating at time of exam. d Two patients with UTI excluded from analysis. e Cardiac symptoms included palpitations, chest pain, congestive heart failure symptoms (eg, orthopnea [cid.oxfordjournals.org]
Musculoskeletal
- Long Legs
DEET containing insect repellent, permethrin-soaked clothing and thick long- sleeved and long – legged clothing may be worn to decrease susceptibility to the bite of mango fly or deer fly. [tajpharma.com]
Using insect repellents (including permethrin -impregnated clothing) and wearing long-sleeved and long-legged clothing may reduce the number of bites by infected flies. Because the flies are day-biting, mosquito (bed) nets do not help. [msdmanuals.com]
Using insect repellents (including permethrin-impregnated clothing) and wearing long-sleeved and long-legged clothing may reduce the number of bites by infected flies. Because the flies are day-biting, mosquito (bed) nets do not help. [merckmanuals.com]
- Arthralgia
Generalized itching, hives, muscle pains, arthralgias, fatigue, and adult worms visibly migrating under the surface of the skin may be observed. [orpha.net]
Pruritus or pricking sensations from adult worm migration, arthralgia, fatigue, and myalgias are common. Eye involvement can cause burning and irritation of the eye. [visualdx.com]
Symptoms described were fever, pruritus, headache, arthralgia. Most symptoms appeared 24 to 36 hours after treatment. Temperature increased significantly in group 3. [ncbi.nlm.nih.gov]
- Muscle Cramp
A 24-year-old woman with paresthesias and muscle cramps after a stay in Africa. N Engl J Med. 2002; 346 :115–122. [ PubMed ] 29. Gallagher B, Khalifa M, Van Heerden P, Elbardisy N. Acute carpal tunnel syndrome due to filarial infection. [ncbi.nlm.nih.gov]
Eyes
- Foreign Body Sensation
She presented to the emergency department with complaints of foreign body sensation, irritation, and described the feeling of something moving in the left eye. [eyetube.net]
R R Hospital, Tirupati with history of pain and foreign body sensation in the left eye, fever, urticarial rash, painless swellings on the ankles, feet and fingers, painless creeping sensation of a worm from the left shoulder, of 1 week duration He had [ijo.in]
- Chemosis
Keywords: Chemosis; Nursing officer; Loa loa; Sub-conjunctiva Subscription required Not yet a registered user? Please Register Here [scitechnol.com]
Trichinosis larvae are also much smaller and characteristically produce circumorbital edema and chemosis 1. Dirofilaria species may present as a nodule in the conjunctiva or eyelid or an adult worm may be found in eye tissues. [scielo.br]
Skin
- Pruritus
A survey from Eastern Cameroon (n = 4146) did not determine the frequency of non-specific pruritus, but showed that among individuals with Calabar swelling pruritus occurred up to 94% [ 29 ]. [ncbi.nlm.nih.gov]
If DEC is contra-indicated due to possible or confirmed co-infection with O. volvulus, ivermectin (150 microgams/kg single dose) treats onchocerciasis, and reduces pruritus and frequency of Calabar swellings. [medicalguidelines.msf.org]
Doxycycline treatment may be particularly beneficial for people with onchodermatitis and pruritus who would otherwise require repeated treatment with ivermectin over a period of years. [emedicine.com]
- Urticaria
Codes ICD10CM: B74.3 – Loiasis SNOMEDCT: 44250009 – Loiasis Look For Subscription Required Diagnostic Pearls Subscription Required Differential Diagnosis & Pitfalls In regions where onchocerciasis and loiasis are endemic, visitors can present with urticaria [visualdx.com]
Systemic reactions include fever, pain, itching, urticaria, and eosinophilia. Dead worms in or near major nerves may cause paresthesias and focal paralyses. [histopathology-india.net]
The swellings may last for 1-3 days, and may be accompanied by localized urticaria (skin eruptions) and pruritis (itching). [the-medical-dictionary.com]
- Subcutaneous Nodule
Movable, nontender subcutaneous nodule of Onchocerca volvulus. [emedicine.com]
In one patient, nonspecific symptoms recurred 2 years later, but unlike her symptoms before albendazole therapy, they were not accompanied by the appearance of subcutaneous nodules containing adult worms. [ncbi.nlm.nih.gov]
Some nodules may contain many male and female worms. In the subcutaneous nodules, the female worms produce microfilariae, which have a lifespan that may reach two years. [patient.info]
- Larva Migrans
Cutaneous larva migrans does not cause eye findings, and the lesions are more superficial and distinct (serpiginous). In Guinea worm infections, the large worm is easily palpable and often partially protruding from the skin. [visualdx.com]
Migrating infective larvae of hookworms and Strongyloides stercoralis are the cause of cutaneous larva migrans and larva currens, respectively. [scielo.br]
Amebiasis Amebic liver abscess Ascariasis Creeping eruption Rectal culture Stool ova and parasites exam Taeniasis Visceral larva migrans [ Read More ] [icdlist.com]
- Chronic Abscess
Dead worms may cause chronic abscesses, which may lead to the formation of granulomatous reactions and fibrosis. Laboratory diagnosis Identification of microfilariae by microscopic examination is the most practical diagnostic procedure. [the-medical-dictionary.com]
Dead worms may cause chronic abscesses, which may lead to the formation of granulomatous reactions and fibrosis. Investigations Eosinophilia is often prominent. [patient.info]
Dead worms may cause chronic abscesses, which may lead to the formation of granulomatous reactions and fibrosis. [en.wikipedia.org]
Urogenital
- Incontinence
By day 2 (D2), many patients experienced confusion, agitation, dysarthria, mutism and incontinence. Some cases of coma were reported as early as D2. The severity of adverse effects increased with higher microfilarial loads. [en.wikipedia.org]
Neurologic
- Peripheral Neuropathy
We report a case of loiasis with unusual clinical complications: a peripheral neuropathy and focal hypo-echogenic lesions of the spleen, which disappeared after treatment with albendazole and ivermectin. [ncbi.nlm.nih.gov]
neuropathy (damaged peripheral nervous system) retinopathy (damaged retina (thin layer on the back wall of the eye)). [parasitesinhumans.org]
- Dysarthria
By day 2 (D2), many patients experienced confusion, agitation, dysarthria, mutism and incontinence. Some cases of coma were reported as early as D2. The severity of adverse effects increased with higher microfilarial loads. [en.wikipedia.org]
Workup
[…] 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.com]
Microbiology
- Paragonimus Westermani
westermani, Paragonimus miyazaki, Clonorchis sinensis, Fasciola hepatica, Cysticercus cellulosae, and Spirometra erinaceieuropaei. [ncbi.nlm.nih.gov]
- Toxocara Canis
The serum was sent for screening for antibodies against the following parasites (SRL, Tokyo, Japan), which turned out to be negative: Dirofilaria immitis, Toxocara canis, Ascaris suum, Anisakis larvae, Gnathostoma spp., Strongyloides stercoralis, Paragonimus [ncbi.nlm.nih.gov]
Other Pathologies
- Tissue Nematode
Filariasis, Loa loa (Pathogen – Tissue Nematode) Organism: Loa loa, the African eye worm, was first noted in the eye of a Negro girl in the West Indies in 1770. [med-chem.com]
Hypertrophy
- Ventricular Hypertrophy
EKG abnormalities included nonspecific T-wave abnormalities, sinus bradycardia or sinus tachycardia, left ventricular hypertrophy, and right axis deviations. [cid.oxfordjournals.org]
Treatment
There was a marked rate of failure after first-line treatment and rare adverse effects were reported. [ncbi.nlm.nih.gov]
Prognosis
Antiparasitic treatment – Diethylcarbamazine (DEC) is the only macrofilaricide available but is contra-indicated in: • Patients with microfilaraemia > 2000 mf/ml (risk of severe encephalopathy, with poor prognosis). • Patients co-infected with O. volvulus [medicalguidelines.msf.org]
Prognosis The prognosis in filariasis is good if infection is recognized and treated early. Filarial diseases are rarely fatal, but the consequences of infection can cause significant personal and socioeconomic hardship for those who are affected. [emedicine.com]
Etiology
(See Pathophysiology and Etiology.) [13] As with most helminths, adult filarial parasites replicate in a definitive host. The adult worm burden in an individual cannot increase unless the host is exposed to additional microfilaria. [emedicine.com]
Parasite Vector 6:283 CrossRef Google Scholar Languillat G, Garin Y, Tursz A, Beauvais B, Lariviere M (1977) Etiological study of low fertility in eastern Gaboon. III. Filarial endemicity (Loa loa, D. perstans). [link.springer.com]
Second, he shared the opinion of Raper 44 that the fibrotic nodules described by Klotz 39 could be attributed to a different etiology, and that L. loa microfilariae in these nodules was probably incidental. 44 We now know that many cases of loiasis are [ncbi.nlm.nih.gov]
Epidemiology
METHODS: Rapid assessment surveys were conducted between 2004 and 2005 using both rapid epidemiological mapping of onchocerciasis (REMO) and rapid assessment procedure for loiasis (RAPLOA). [ncbi.nlm.nih.gov]
Methods: Rapid assessment surveys were conducted between 2004 and 2005 using both rapid epidemiological mapping of onchocerciasis (REMO) and rapid assessment procedure for loiasis (RAPLOA). [ntdenvision.org]
Rapid Epidemiological Mapping of Onchocerciasis (REMO) was conducted in the state in 1996 and annual mass ivermectin distribution started in 2000 and it is still ongoing. [journals.plos.org]
Pathophysiology
The pathophysiological mechanisms are discussed in the light of these observations and the few other comments on this subject published in the literature. [ncbi.nlm.nih.gov]
Pathophysiology The filarial life cycle, like that of all nematodes, consists of 5 developmental (larval) stages in a vertebral host and an arthropod intermediate host and vector. [emedicine.com]
An understanding of the pathophysiology of these post-treatment reactions is necessary in order to develop strategies to prevent these reactions in the future. [clinicaltrials.gov]
The immune downregulation seen among END appears to be related to factors independent of microfilariae, but the underlying pathophysiology of these differences is not known. [cid.oxfordjournals.org]
Prevention
We conclude that diethylcarbamazine given orally once weekly can be an effective, acceptable chemoprophylactic agent to prevent loiasis in temporary residents of regions of Africa where Loa loa is endemic. [ncbi.nlm.nih.gov]
For a description of CDC’s information for preventing insect bites, see CDC’s Yellow Book. [globalinfoonline.com]
Objectives: - To determine whether reslizumab can prevent or reduce the side effects of treatment with DEC for Loa loa infection. [clinicaltrials.gov]
Abstract To determine whether infection with Loa loa could be prevented in temporary residents of endemic areas, we conducted a randomized, double-blind, placebo-controlled trial of diethylcarbamazine as a chemoprophylactic agent. [nejm.org]