[…] diethylcarbamazine in onchocerciasis, most commonly an intensely pruritic rash, but sometimes also systemic manifestations such as fever, malaise, lymph node swelling, eosinophilia, arthralgias, tachycardia, and hypotension; if numerous microfilariae are present [medicine.en-academic.com]

This presents acutely with fluctuating focal neurological signs and meningitis, with eosinophils in peripheral blood and cerebrospinal fluid. [europeanmedical.info]

Signs_and_symptoms Symptoms Typically, patient present with cutaneous symptoms including itching and dermatologic changes years before the onset of ocular symptoms. [flipper.diff.org]

Age Most patients presenting with the malignant form are 40-80 years. The average age at onset of the malignant form is about 60 years. [emedicine.medscape.com]

• Fever

  Even so, nearly one-fourth of patients treated with ivermectin develop isolated fever or pruritis without the remaining constellation of symptoms. [journals.lww.com]

  Clinical findings Intense pruritic rash, fever, malaise, lymphadenopathy, eosinophilia, arthralgia, tachycardia, hypotension, oedema, abdominal pain. Mazzotti, Luigi, Mexican parasitologist, 1900-1971. [medical-dictionary.thefreedictionary.com]

  The patient was hospitalized with fever, urticaria, abdominal pain and angioedema. Twelve hours after treatment with intravenous methylprednisolone he had complete resolution of his symptoms. [unboundmedicine.com]

• Pain

  Clinical findings Intense pruritic rash, fever, malaise, lymphadenopathy, eosinophilia, arthralgia, tachycardia, hypotension, oedema, abdominal pain. Mazzotti, Luigi, Mexican parasitologist, 1900-1971. [medical-dictionary.thefreedictionary.com]

  The patient was hospitalized with fever, urticaria, abdominal pain and angioedema. Twelve hours after treatment with intravenous methylprednisolone he had complete resolution of his symptoms. [unboundmedicine.com]

• Swelling

  […] reactions, which may be severe or rarely life-threatening, that accompany the administration of diethylcarbamazine in onchocerciasis, most commonly an intensely pruritic rash, but sometimes also systemic manifestations such as fever, malaise, lymph node swelling [medicine.en-academic.com]

  He had bulbar and palpebral conjunctival injection and angioedema of his face, with mild swelling of his lower extremities and penis. [journals.lww.com]

  Loiasis is less damaging and diagnosis is based on fleeting subcutaneous swellings, known as Calabar swellings. Infection may be associated with fever and abnormalities of renal function. [biocyclopedia.com]

• Inflammation

  David Evered, Sarah Clark John Wiley & Sons, ٣٠‏/٠٤‏/٢٠٠٨ - 316 من الصفحات Filarial parasites affect over 130 million people in tropical and subtropical regions of the world, causing prolonged and debilitating illnesses ranging from lymphatic inflammation [books.google.com]

  Ocular migration into the anterior segment and the associated inflammation leads first to punctate keratitis. This is more common in younger people and is reversible. [isradiology.org]

  Skin involvement typically consists of intense itching, swelling, and inflammation. O. volvulus involves all ocular tissues. [flipper.diff.org]

  Inflammation in the eye causes blindness. Loiasis is less damaging and diagnosis is based on fleeting subcutaneous swellings, known as Calabar swellings. Infection may be associated with fever and abnormalities of renal function. [biocyclopedia.com]

• Asymptomatic

  […] postural hypotension, asymptomatic decrease in MAP by ≥35 mmHg relative to baseline after 2 min standing still following ≥5 minutes supine. 4 SSPH severe symptomatic postural hypotension, diagnosed when a subject cannot stand still for 2 minutes after [plos.figshare.com]

  This condition is less commonly seen in travellers after their return, when filariasis is usually asymptomatic. [europeanmedical.info]

  Low worm burden are asymptomatic. Heavy infection problematic especially in children where they are associated with impaired development Predisposing factor to infection: poor hygiene. 12 Ascaris lumbricoides. [slideplayer.com]

  Clinical Characteristics Early or minor infection can be asymptomatic, but onchocerciasis can be a serious infection. The blackfly bites are painful and may bleed. Multiple bites in the nonimmune result in urticaria and itching. [isradiology.org]

  […] are infected with Strongyloides stercoralis and 22% are infected with both.1 Similarly, 69% and 23% of Somali Bantu refugees were found to have schistosomiasis and strongyloidiasis, respectively.2 Presumptive treatment, even for those refugees who are asymptomatic [journals.lww.com]

• Abdominal Pain

  Clinical findings Intense pruritic rash, fever, malaise, lymphadenopathy, eosinophilia, arthralgia, tachycardia, hypotension, oedema, abdominal pain. Mazzotti, Luigi, Mexican parasitologist, 1900-1971. [medical-dictionary.thefreedictionary.com]

  The patient was hospitalized with fever, urticaria, abdominal pain and angioedema. Twelve hours after treatment with intravenous methylprednisolone he had complete resolution of his symptoms. [unboundmedicine.com]

• Vomiting

  Gastrointestinal effects, such as abdominal pain, nausea, and vomiting. Alopecia (albendazole). 3) Pregnancy risk: C. 2. [empendium.com]

  DIETHYLCARBAMAZINE CITRATE - Indications DOC for filariasis, loiasis, and tropical eosinophilia DIETHYLCARBAMAZINE CITRATE Adverse Reactions / Toxicity Toxicity –headache, dizziness, nausea, and vomiting. [freezingblue.com]

  […] patients in four clinical studies given either 1 or 2 doses of 170-200 microgram/kg of ivermectin: Body as a Whole : Asthenia/fatigue (0.9%), abdominal pain (0.9%) Gastrointestinal : Anorexia (0.9%), constipation (0.9%), diarrhea (1.8%), nausea (1.8%), vomiting [web.stanford.edu]

  • Transient mild GI symptoms (epigastric pain, diarrhea, nausea, and vomiting) occur in ~1% of treated individuals with Albendazole • In long-term therapy of cystic hydatid disease and neurocysticercosis most common side effect is liver dysfunction, [slideshare.net]

  Symptoms: nausea, vomiting, headache, dizziness, drowsiness and severe convulsions Conduct, medical supervision and symptomatic treatment Pregnancy Studies in the animal have not demonstrated any teratogenic effect. [healthician.org]

• Hypotension

  Clinical findings Intense pruritic rash, fever, malaise, lymphadenopathy, eosinophilia, arthralgia, tachycardia, hypotension, oedema, abdominal pain. Mazzotti, Luigi, Mexican parasitologist, 1900-1971. [medical-dictionary.thefreedictionary.com]

  asymptomatic decrease in MAP by ≥35 mmHg relative to baseline after 2 min standing still following ≥5 minutes supine. 4 SSPH severe symptomatic postural hypotension, diagnosed when a subject cannot stand still for 2 minutes after ≥5 minutes supine due [plos.figshare.com]

  Hypotension, fever, adenitis and pruritus were all correlated with infection intensity in these patients while… CONTINUE READING [semanticscholar.org]

• Tachycardia

  Clinical findings Intense pruritic rash, fever, malaise, lymphadenopathy, eosinophilia, arthralgia, tachycardia, hypotension, oedema, abdominal pain. Mazzotti, Luigi, Mexican parasitologist, 1900-1971. [medical-dictionary.thefreedictionary.com]

  Hypotension, fever, adenitis and pruritus were all correlated with infection intensity in these patients while arthralgia and tachycardia were not. [scinapse.io]

• Conjunctival Injection

  He had bulbar and palpebral conjunctival injection and angioedema of his face, with mild swelling of his lower extremities and penis. [journals.lww.com]

• Arthralgia

  Clinical findings Intense pruritic rash, fever, malaise, lymphadenopathy, eosinophilia, arthralgia, tachycardia, hypotension, oedema, abdominal pain. Mazzotti, Luigi, Mexican parasitologist, 1900-1971. [medical-dictionary.thefreedictionary.com]

  Hypotension, fever, adenitis and pruritus were all correlated with infection intensity in these patients while arthralgia and tachycardia were not. [scinapse.io]

• Myalgia

  Abstract Dear Editor, The Mazzotti reaction, originally described by Mazzotti (1948), is a complex of symptoms characterized by fever/chills, swollen and tender lymph nodes (lymphadenitis), headache, myalgia, arthralgia, tachycardia, hypotension/shock [deepdyve.com]

  Drug-related headache and myalgia occurred in [web.stanford.edu]

  Detailed monitoring identified some side effects in almost all patients: usually fever, headache, lightheadedness, myalgia, sore throat, or cough that occurred most prominently 18 to 36 hours after treatment. [jamanetwork.com]

  Indirect effects such as fever, pruritus, urticaria, rashes, arthralgia, and myalgia are noted occasionally. [slideshare.net]

  Drug-related headache and myalgia occurred in < 1% of patients (0.2% and 0.4%, respectively). However, these were the most common adverse experiences reported overall during these trials regardless of causality (22.3% and 19.7%, respectively). [rxlist.com]

• Pruritus

  Hypotension, fever, adenitis and pruritus were all correlated with infection intensity in these patients while… CONTINUE READING [semanticscholar.org]

  Hypotension, fever, adenitis and pruritus were all correlated with infection intensity in these patients while arthralgia and tachycardia were not. [scinapse.io]

• Urticaria

  The allergic-type symptoms seen in the Mazzotti reaction, such as the pruritic urticaria and edema are easily explained by this mechanism. [journals.lww.com]

  The patient was hospitalized with fever, urticaria, abdominal pain and angioedema. Twelve hours after treatment with intravenous methylprednisolone he had complete resolution of his symptoms. [unboundmedicine.com]

  Mazzotti reactions can be life-threatening, and are characterized by fever, urticaria, swollen and tender lymph nodes, tachycardia, hypotension, arthralgias, oedema, and abdominal pain that occur within seven days of treatment of microfilariasis. [enacademic.com]

• Angioedema

  The patient was hospitalized with fever, urticaria, abdominal pain and angioedema. Twelve hours after treatment with intravenous methylprednisolone he had complete resolution of his symptoms. [unboundmedicine.com]

  He had bulbar and palpebral conjunctival injection and angioedema of his face, with mild swelling of his lower extremities and penis. [journals.lww.com]

• Skin Patch

  The phenomenon is so common when DEC is used for the treatment of onchocerciasis that this drug is the basis of a skin patch test used to confirm that diagnosis. [enacademic.com]

  The drug patch is placed on the skin, and if the patient is infected with the microfilaria of O. volvulus, localized pruritus and urticaria are seen at the application site. [en.wikipedia.org]

  patch test used to confirm that diagnosis. [journals.lww.com]

• Dermatitis

  The patch is then checked for local dermatitis caused by the dying microfilariae. This is safer than the Mazzotti test because there is no risk of provoking a systemic reaction, but is not as sensitive as a skin snip. [web.stanford.edu]

  Patients with hyperreactive onchocerciasis dermatitis or Sowda (observed particularly in Yemen) appear to develop more frequently severe skin reactions (edema, aggravation, dermatitis ...) after microfilaricidal treatment. > • Ocular reaction: when [healthician.org]

  These nodules present concurrently with the development of diffuse papular dermatitis, orange-peel textured skin, linchenified dermatitis, atrophy, fine wrinkles, lymphadenitis ("hanging groin"), and eventually depigmentation (“leopard skin”).1 In Sierra [flipper.diff.org]

  Rarer side effects of Ivermectin include severe cutaneous and systemic allergic reactions, worsening of dermatitis and encephalopathy. Click HERE To Buy Ivermectin Online [meridian-group.com]

• Suggestibility

  It is suggested that the clinical features of the reaction may be due to the effects of mediators secreted from inflammatory cells including eosinophils, in sites where microfilarae are being destroyed. [ugspace.ug.edu.gh]

  Although the pathogenesis of the Mazzotti reaction is clearly complex, our results indicate that eosinophil degranulation is characteristic of the response and that it occurs with a time course suggestive of a role for the eosinophil in determining the [ncbi.nlm.nih.gov]

  […] patients living in area endemic for onchocerciasis and leprosy manifested borderline leprosy or lepromatous-like symptoms when parasitic condition treated with diethylcarbamazine, also frequently had suppression of Mazzotti reaction, patient histories suggest [agris.fao.org]

• Salpingitis

  Salpingitis or even peritonitis is a rare complication in female patients. Pyrantel pamoate, mebendazole, or albendazole as a single dose are highly effective in the treatment of Enterobius infection. [accesspharmacy.mhmedical.com]

• Headache

  Clinically this is manifested with general symptoms such as fever, itching, hypotension, lymphadenitis, arthritis, abdominal pain and headaches. Isolated anaphylactic reactions are described. [altmeyers.org]

  Abstract Dear Editor, The Mazzotti reaction, originally described by Mazzotti (1948), is a complex of symptoms characterized by fever/chills, swollen and tender lymph nodes (lymphadenitis), headache, myalgia, arthralgia, tachycardia, hypotension/shock [deepdyve.com]

  Abdominal discomfort, particularly pain and nausea, diarrhea, headache, dizziness, and drowsiness may occur shortly after taking praziquantel; these direct effects are transient and dose related. [slideshare.net]

  Drug-related headache and myalgia occurred in [web.stanford.edu]

• Giddiness

  • Less frequently, diarrhea, fatigue, drowsiness, giddiness, or headache occur • Thiabendazole has hepatotoxic potential. • Thiabendazole in pregnant women have not been studied adequately. 16. • MOA • The mechanism of action of DEC against susceptible [slideshare.net]

• Wuchereria Bancrofti

  These actions result in Ivermectin being lethal to nematodes like Ascaris lumbricoides, Strongyloides stercoralis and other parasites like Wuchereria bancrofti and Loa loa. [meridian-group.com]

  June 3, 1988 Ivermectin for the Treatment of Wuchereria bancrofti Filariasis: Efficacy and Adverse Reactions JAMA. 1988;259(21):3150-3153. doi:10.1001/jama.1988.03720210040026 Full Text Ivermectin treatment was evaluated for efficacy and side effects [jamanetwork.com]

  bancrofti and Brugia malayi that cause lymphatic filariasis, and Onchocerca volvulus, which causes onchocerciasis (river blindness). [karger.com]

  Lymphatic filariasis is caused by the parasitic nematode worms Wuchereria bancrofti, Brugia malayi and B. timori. [apps.who.int]

Coadministration of albendazole is also recommended for presumptive treatment of other intestinal parasites. [journals.lww.com]

Twelve hours after treatment with intravenous methylprednisolone he had complete resolution of his symptoms. [unboundmedicine.com]

This decrease was followed by a marked eosinophilia developing over the remaining 7 days of treatment and 14 days of follow-up. [ncbi.nlm.nih.gov]

Francis H et al (1985) The Mazzotti reaction following treatment of onchocerciasis with diethylcarbamazine: clinical severity as a function of infection intensity. [altmeyers.org]

PMID: 6760823 Prognosis Awadzi K, Opoku NO, Addy ET, Quartey BT Trop Med Parasitol 1995 Jun;46(2):131-7. PMID: 8525285 Ackerman SJ, Kephart GM, Francis H, Awadzi K, Gleich GJ, Ottesen EA J Immunol 1990 May 15;144(10):3961-9. [ncbi.nlm.nih.gov]

Reactive angioendotheliomatosis has a good prognosis and usually regresses when the underlying disease, if discovered, is successfully treated. The disease sometimes regresses spontaneously. The prognosis depends on the underlying cause. [emedicine.medscape.com]

Etiology Trop Med Parasitol 1995 Jun;46(2):131-7. PMID: 8525285 Duke BO Acta Leiden 1990;59(1-2):9-24. PMID: 2198761 Büttner DW, von Laer G, Mannweiler E, Büttner M Tropenmed Parasitol 1982 Dec;33(4):201-12. [ncbi.nlm.nih.gov]

[…] visitors to endemic areas Requires exposure in endemic area for at least a few months Age: usually occurs in 20-40 y/o Sex: 80% of cases are males Race: Indians are most susceptible Possible relationship to Tropical Myocardial Fibrosis (unclear though) Etiology [mdnxs.com]

Laboratory Diagnosis Pruritus is a common and complex problem in the tropics, and may be the result of many infectious and noninfectious etiologies. Skin snips and scrapings are commonly obtained whenever infection is considered. [isradiology.org]

Etiology Different triggers (eg, subacute bacterial endocarditis; circulating immune complexes; fibrin; cholesterol emboli; viruses, such as hepatitis C; atriovenous fistula [17] ; atherosclerotic emboli; trauma; metal implants [18] ; drugs such as trabectedin [emedicine.medscape.com]

The etiology and incidence of anaphylaxis in Rochester, Minnesota: a report from the Rochester Epidemiology Project. J Allergy Clin Immunol 2008; 122: 1161–1165 PubMedCentral PubMed CrossRef Google Scholar 14. [doi.org]

Lopes Medicine Drugs 2012 Ivermectin, used in mass treatment, may also improve the epidemiological situation, reducing the level of microfilariae in the skin of infected people and thus reducing the source for vector infestation. [semanticscholar.org]

International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings. Acta Trop 2003;85:253–261. [doi.org]

However, the cost is justifiable only when epidemiological data indicate that more than 5% of the population is infected. Simple diagnostic blood tests can be used to estimate the prevalence of microfilaraemia. [apps.who.int]

Epidemiology Most common in Southeast Asia, India, South Pacific > Africa, South America (but cases have occurred in North American and European visitors to endemic areas Requires exposure in endemic area for at least a few months Age: usually occurs [mdnxs.com]

They also address the consequences of drug interactions and the basic pathophysiology of central nervous system toxicity. [books.google.com]

Onchocerciasis River_Blindness -Pathophysiology (African_River_Blindness)#Pathophysiology Primary prevention Global preventative efforts are currently concentrated in population-based prophylactic treatment through programs such as the African Programme [flipper.diff.org]

Pathophysiology The pathogenesis of reactive angioendotheliomatosis is still not fully elucidated. [emedicine.medscape.com]

Clinical observations on the pathophysiology and treatment of anaphylactic cardiovascular collapse. Anaesth Intensive Care 1986; 14: 17–21 PubMed Google Scholar 32. Pumphrey RS, Roberts IS. Postmortem findings after fatal anaphylactic reactions. [doi.org]

Center for Disease Control and Prevention. Recommendations for presumptive treatment of schistosomiasis and strongyloidiasis among the Somali Bantu refugees. [journals.lww.com]

Prevention and control An international onchocerciasis control programme is under way, using mass treatment of whole populations with ivermectin and doxycycline. Lymphatic filariasis is prevented by mosquito-control measures. [biocyclopedia.com]