Lymphatic filariasis

Question 1

What is a common parasitic cause of Elephantiasis in the tropics?

Answer 1

A common cause is the parasitic worm Wuchereria bancrofti, transmitted by mosquitoes.

Question 2

What are the early symptoms of Lymphatic Filariasis caused by Wuchereria bancrofti?

Answer 2

Early symptoms include mild lymphangitis, lymphadenitis, and pitting edema of one or more extremities or genitals. The lymphadenitis is descending rather than ascending.

Question 3

How does Lymphatic Filariasis progress over time?

Answer 3

Initially, there are attacks of swelling, but the symptoms become chronic over time, leading to firm lymphoedema of the extremities, vulva, scrotum, arms, and breasts, often with a warty appearance and folds and cracks in the lower legs and feet.

Question 4

How is active infection of Lymphatic Filariasis diagnosed?

Answer 4

Active infection can be diagnosed with a rapid card test using fingerprick blood.

Question 5

What is the management approach for Lymphatic Filariasis?

Answer 5

Management includes:
Keeping the skin clean and managing intercurrent infections
Exercises to improve lymphatic flow, lymph massage, intermittent compression, and using elastic compression bandages, stockings, or lace-up boots
Ivermectin 12 mg plus albendazole 400 mg in a single dose for adults to kill microfilariae, repeated yearly until all adult worms have died of old age (3-4 years)