Filarial worms Flashcards
Nematodes that are found in the ________ and _________
blood and the
lymphatics
Vector Transmitted by _______ vectors such as
mosquitoes
Arthropod
Prevalent of all the filarial worms
Wuchereria bancrofti
Not that prevalent
Brugia malayi
Most cases are found in Asia
Brugia malayi
Wuchereria bancrofti
Can live for around ___ years in the lymphatic vessels
10
Wuchereria bancrofti
Common Name
Bancroft’s Filarial Worm
Wuchereria bancrofti
Certain periodic time when the adult worms release the microfilaria from ________ to the _______
- lymphatic vessels
- bloodstream
Wuchereria bancrofti
________ in appearance if found in the
lymphatic vessels
Whitish or creamy
Wuchereria bancrofti
Final Host
Humans
Wuchereria bancrofti
Intermediate Host
Mosquitoes
Vectors
Wuchereria bancrofti
Mosquitoes
Vectors:
- Aedes poecilus
- Anopheles flavirostris
- Culex
Wuchereria bancrofti
Infective to FH/Humans
3rd stage Larva (L3 Filiform)
Wuchereria bancrofti
Infective to IH and
Diagnostic stage for FH
microfilaria (found in the blood)
Wuchereria bancrofti
MOT
Larval Penetration
Wuchereria bancrofti
Habitat of Adults
Lymphatics
Wuchereria bancrofti: Life Cycle
Mosquito infected with _______ takes a blood meal
L3 larva
Wuchereria bancrofti: Life Cycle
after the blood meal, there will be drops of blood left over from the _____
proboscis
Wuchereria bancrofti: Life Cycle
Mosquito does not inject directly the L3 larva, the larva actively penetrates the _________ caused by the proboscis
puncture wound
Wuchereria bancrofti: Life Cycle
_______ in the proboscis will actively move
into the puncture wound
L3 Larva
Wuchereria bancrofti: Life Cycle
L3 Larva will find its way to the ________ where it will develop into an adult worm
lymphatics
Wuchereria bancrofti: Life Cycle
Adult worms become sexually mature for
approximately _________
7 months
Wuchereria bancrofti: Life Cycle
Female worm will produce partially ________
embryonated egg
Wuchereria bancrofti: Life Cycle
partially embryonated egg will eventually become the ______
microfilariae
Wuchereria bancrofti: Life Cycle
is a modified type of egg
Microfilaria
Wuchereria bancrofti: Life Cycle
Inside the microfilaria is an embryo that is developing that becomes _______
elongated
Wuchereria bancrofti: Life Cycle
Microfilaria will be found first in the capillary and blood vessels of the ____, then the peripheral blood
lungs
Wuchereria bancrofti: Life Cycle
Mosquito will take another blood meal, getting the
________
microfilaria
Wuchereria bancrofti: Life Cycle
Once ingested by the mosquito, the _____ will be removed and the unsheathed microfilariae will penetrate the _______
- sheath
- midgut
Wuchereria bancrofti: Life Cycle
After going in the midgut of the mosquito, it will go to the ______________
thoracic muscles
Wuchereria bancrofti: Life Cycle
L1 larva will become an L3 larva which will go to the mosquito’s ______
proboscis
Wuchereria bancrofti: Under the Microscope
What specimen will you use?
Fresh blood specimen under LPO
Wuchereria bancrofti: Under the Microscope
Characteristic movement:
graceful and smooth
Wuchereria bancrofti: Under the Microscope
____ microfilaria compared to Brugia malayi
Longer
Wuchereria bancrofti: Under the Microscope
Cephalic space:
breadth ratio (1:1)
Wuchereria bancrofti: Under the Microscope
clear part of
the microfilaria; has space
Cephalic space
Wuchereria bancrofti: Under the Microscope
width/kapal of the microfilaria
Breadth
Wuchereria bancrofti: Under the Microscope
Body nuclei:
Regularly Spaces;
Not Overlapping
Wuchereria bancrofti: Under the Microscope
Mean Length
290 um
Wuchereria bancrofti: Under the Microscope
Sheath
(Staining)
Sheathed;
Unstained with
Giemsa
Wuchereria bancrofti: Under the Microscope
Tail
Single Row of Nuclei
that doesn’t reach
tail’s end
Wuchereria bancrofti: Under the Microscope
Terminal Nuclei
None
Wuchereria bancrofti: Under the Microscope
Appearance in
Blood Films
Graceful; Smoothly
Curved
Wuchereria bancrofti: Under the Microscope
Periodicity (adult worms release the microfilaria during a specific period of time)
Nocturnal (10 PM to
2 AM)
Brugia malayi
Intermediate Host:
- Mansonia bonneae
- Mansonia uniformis
- Anopheles
Brugia malayi
Common Name:
Malayan Filarial Worm
Brugia malayi: Under the Microscope
Mean Length
222 um
Brugia malayi: Under the Microscope
Cephalic
Space:Breadth
2:1
Brugia malayi: Under the Microscope
Sheath
(Staining)
Sheathed; Pink
with Giemsa
Brugia malayi: Under the Microscope
Nuclei
Irregularly Space;
Overlapping
Brugia malayi: Under the Microscope
Tail
Single Row of
Nuclei that reach
tail’s end
Brugia malayi: Under the Microscope
Terminal Nuclei
Yes, 2 nuclei
Brugia malayi: Under the Microscope
Appearance in
Blood Films
Kinky
Filarial Worms: Disease Manifestation
has an acute and chronic phase
Lymphatic Filariasis
Brugia malayi: Under the Microscope
Periodicity (adult worms release the microfilaria during a specific period of time)
Subperiodic (12
NN to 8 PM
Filarial Worms: Disease Manifestation
Lymphatic filariasis caused by Wuchereria bancrofti would be more _____ compared to Brugia malayi.
severe
Filarial Worms: Disease Manifestation
Asymptomatic Phase: thousands to millions of microfilaria in the _____ and adult worms in the _________
Lymphatic Filariasis
- blood
- lymphatics
Filarial Worms: Disease Manifestation
Early manifestation:
Lymphatic Filariasis
- Fever
- Lymphadenitis
- Swelling
- Redness of Arms and Legs
- Vomiting
- Headache
Filarial Worms: Disease Manifestation
lymph nodes are inflamed
Lymphatic Filariasis
Lymphadenitis
Filarial Worms: Disease Manifestation
Most common acute manifestation of LF
Lymphatic Filariasis
acute dermatolymphangioadenitis
(adenolymphangitis)
ADLA
Filarial Worms: Disease Manifestation
Chronic Phase:
Lymphatic Filariasis
- Elephantiasis
- Hydrocoele
- Chylocoele
- Lymphocoele; Chyluria
Filarial Worms: Disease Manifestation
Chronic Phase: After _____ years since infection
Lymphatic Filariasis
10-20
Filarial Worms: Disease Manifestation
Chronic Phase: Death of _______ will cause obstruction and inflammation in the lymphatic vessel
Lymphatic Filariasis
adult worms
Filarial Worms: Disease Manifestation
most common
chronic manifestation
Lymphatic Filariasis
Lymphedema
Filarial Worms: Disease Manifestation
accumulation of lymphatic fluid
Lymphatic Filariasis
Elephantiasis
Filarial Worms: Disease Manifestation
certain parts of the body are enlarged
Lymphatic Filariasis
Elephantiasis
Filarial Worms: Disease Manifestation
Chronic Phase: Result in ______, changes in the morphology of the lymphatic vessels
Lymphatic Filariasis
fibrosis
Filarial Worms: Disease Manifestation
enlargement of scrotum in males
Lymphatic Filariasis
Hydrocoele
Filarial Worms: Disease Manifestation
can affect the vulva in females
Lymphatic Filariasis
Hydrocoele
Filarial Worms: Disease Manifestation
Lymphatic fluid can be recovered in
urine samples
Lymphatic Filariasis
Chyluria
Filarial Worms: Disease Manifestation
Once the chronic phase starts, and there is already enlargement of those affected parts of the body, then it is no longer ______.
Lymphatic Filariasis
reversible
Filarial Worms: Disease Manifestation
In Wuchereria bancrofti, the enlargement is
usually _______
Lymphatic Filariasis
below the waist.
Filarial Worms: Disease Manifestation
Paroxysmal Nocturnal cough
Tropical Pulmonary Eosinophilia
Filarial Worms: Disease Manifestation
the patient would experience
coughing during the night
Tropical Pulmonary Eosinophilia
Paroxysmal Nocturnal cough
Filarial Worms: Disease Manifestation
Hypereosinophilia
Tropical Pulmonary Eosinophilia
Filarial Worms: Disease Manifestation
Lung infection is impaired
Tropical Pulmonary Eosinophilia
Filarial Worms: Disease Manifestation
Microfilaria would initially be found in the
lung tissue
Tropical Pulmonary Eosinophilia
Filarial Worms: Disease Manifestation
“hidden”.
Microfilaria can’t be detected yet in
the peripheral blood.
Tropical Pulmonary Eosinophilia
Occult Filariasis
Filarial Worms: Disease Manifestation
may also occur during the acute phase of
Lymphatic Filariasis
Tropical Pulmonary Eosinophilia
Filarial Worms: Diagnosis
- Thick Smears
- Diethylcarbamazine Provocative Test
- Concentration Techniques
- Serology
- Molecular Methods
- Ultrasonography
Filarial Worms: Diagnosis
Stain for thick smears
Giemsa stained
Filarial Worms: Diagnosis
Objectives used in microscopy
LPO (Low power objective lens)
Filarial Worms: Diagnosis
W. bancrofti time of blood collection
10pm to
2am (Nocturnal periodicity
Filarial Worms: Diagnosis
B. malayi time of blood collection
12nn to 8 pm (Subperiodic Periodicity)
Filarial Worms: Diagnosis
no need to wake up early to get blood sample
Diethylcarbamazine Provocative Test
Filarial Worms: Diagnosis
increased chance of detecting filarial worms
Diethylcarbamazine Provocative Test
Filarial Worms: Diagnosis
How much DEC is needed in Diethylcarbamazine Provocative Test
3mg/kg
Filarial Worms: Diagnosis
Two types of Concentration Techniques
- Knott’s Concentration Technique
- Membrane filtration Method (Nuclepore filter)
Filarial Worms: Diagnosis
____ of whole blood + _____ of 2% formalin
Knott’s Concentration Technique
- 1mL
- 10mL
Filarial Worms: Diagnosis
Preserves the microfillaria in centrifugation
Knott’s Concentration Technique
2% formalin
Filarial Worms: Diagnosis
After centrifuge, get the ________
and stain it with giemsa then examine under the microscope.
Knott’s Concentration Technique
sediment
Filarial Worms: Diagnosis
filter set-up allowing the blood to pass through the filter
Membrane filtration Method (Nuclepore filter)
Filarial Worms: Diagnosis
the _______ would remain in the filter since it is bigger
Membrane filtration Method (Nuclepore filter)
microfilaria
Filarial Worms: Diagnosis
The _________ will be stained and examined under the microscope.
Membrane filtration Method (Nuclepore filter)
membrane filter
Filarial Worms: Diagnosis
Detection of Circulating Filarial Antigen
Serology
Filarial Worms: Diagnosis
Rapid Diagnostic Test antigens used:
- Ag BmR1(Brugia Rapid)
- WbSXP-1
Filarial Worms: Diagnosis
more appropriate during the chronic phase
Ultrasonography
Filarial Worms: Diagnosis
The examination of ________ would be helpful in the acute phase because once the patient is already in the chronic phase, the microfilaria will not be detected because the adult worms are already dead.
blood smears
Filarial Worms: Treatment
Main drug
Diethylcarbamazine
Filarial Worms: Epidemiology
more widespread, affects India, SEA, Pacific Islands, Africa, and South and Central America
Bancroftian Filariasis
Filarial Worms: Epidemiology
affects SEA
Malayan Filariasis
Filarial Worms: Treatment
Other drugs:
○ Ivermectin
○ Albendazole
○ Doxycycline
In order for you to develop a disease, you should be ________ by the infected mosquito.
repeatedly bitten
Based on statistics, Filariasis would be more common among the population of _____ but would
depend on their occupation
males
In the Philippines, most cases of Filariasis will be found in the _______ and some parts of ________ and _______
- Bicol region
- Visayas and Mindanao.
Transmission of Filariasis can be due to the availability of the breeding sites for mosquitoes (where water can accumulate):
- Musa textilis (abaca)
- Colocasia esculenta
- Water lilies
__________ have a higher chance of getting infected by Filariasis.
Agricultural workers
Malayan Filariasis is seen in:
- Palawan
- Eastern Samar
- Agusan del Sur
- Sulu
Quite similar to Wuchereria bancrofti but longer than
Brugia malayi
Brugia timori
Disease is seen more in ____ than children
adults
Similar to bancroftian filariasis in clinical presentation
Brugia timori
Microfilaria longer than _______
Brugia timori
B. malayi
Cephalic space
Brugia timori
3:1
Sheath
Brugia timori
unstained by Giemsa
Periodicity
Brugia timori
Nocturnal
Vector
Brugia timori
Anopheles barbirostris
can be found in Indonesia