filariasis

FilariasisBy; Amani Ramadan.

Al zahraa

Atef .

Alaa abd El Hakeem.

worm DiseaseWuchereria bancrofti.

. Bancroftian filariasis

Brugia malayi.

Loa loa Loiasis.

Onchocercus volvulus. Onchocercosis.

Mansonella perstans. Mansonellasis.

Mansonella ozzardi .

Wuchereria bancrofti

tropical regions. . far east

Egypt : Rasheed, Kerdasa,

Sharkia, Menoufiya

( Ashmoon ,menoof )

:Geographical distribution

Habitat:Vessels of lymph nodes and lymph

•Lower limb , external genitalia , trunk .

DH:• Man

IM: Culex pipiens ,Ades ,anopheles

Culex pipiensAedes

Anopheles

:Brugia malayi

Far east ; Malaysia,

India , china.

Habitat; Lymphatic tissue of upper

limb and mamary glands.

IH: Mansonia , Aedes.

RH; Monkeys ,cats.

Life cycle:

Bancroftian filariasis

Def:• Pathological lesions occur

in the lymphatic system , due to the presence of adult worms(living or dead) but not due to

microfilariae .

symptoms start3_12months after

infection.

phases

ObestructiveTropical

pulmonary eosinophilia

Acute inflammatory

Asymptomatic

Asymptomatic phase;

In endemic areas ,patient with

microfilaria with no symptoms .

Acute inflammatory phase ;

Attacks of lymphang itis and

lymphadenitis

Due to;

toxic products, mechanical irritation,

allergic reactions, 2ry bacterial infection.

Symptoms ;

Systemic ;

Local lymphangitis. (affected lymph vessels of leg are( raised ,red , swollen tender streaks.)

Lymphadenitis. )legs , epi didymis, tests , scrotaum,

Spermatic cord , vulva (

HeadacheFever

TROPICAL PULMONARY EOSINOPHILIA:

1 .no lymphatic pathology.

2 .no microfilaria in blood . but appears in lung.

3 .Lung opacities and cough and wheeze .

4 .Marked esinophilia , IGE

OBSTRUCTIVE PHASE;

CAUSES; 1.warms.

2.hyperplasia. 3.stenosis. 4 .fibrosis.

EFFECTS;

1.Dilated,varicosed lymph vessels . 2.Oedema.

3.rupture of distended vessels. 4.Eliphantiasis.

Chylo thorax

Chylous ascitis Chyluria

Elephantiasis >Results of complex immune

responses(5_10 years)

1 .Thickening of affected part.

2 .Hard ,dense , non piting and non elastic skin .

3 .Folded,fissured skin 2ry

bacterial infection .

4.No microfilaria in blood.

Diagnosis ;

*Clinical.*Laboratory.

1 -Blood examination; - Wet mount preparation .

- stained thick and thin.blood film

microfilaria

_Concentration techniques:

- Modifiedknott”s method.

- Pandit s test

-Diethylcarbamazine provocative test.

2-Urine examination; urine sample of chyluria+ 2ml ether

>>>centrifugation and examination under microscope.

3-X rays for calcified adult.

4-Aspiration of lymphnodes.

5-Immunodiagnosis;(ELISA,IFAT,CFT,IHAT) detecting antibodies using Dirofilaria immitis antigen.

6-PCR.7-Eosinophilia(6-26%). Filaria of dog

Loa loa

Cameroon

Habitat: cojunctiva ,

eyelid ,loose subcutaneous tissue.

IH: Chrysops fly ( golden

eye fly)

RH ; Monkeys , rodents .

Life cycle

Loiasis; -Irritation and itching in cornea.

- localized calabar swelling; 1 -allergic reaction.

2-appears rapidly for 2-3 days then disappear.egg(Hard, painful, non piting) 3-Hen.

- Encephalitis .

- Arthritis.

Diagnosis; clinical;

1-Observation of adult worm under conjunctiva or over the nose bridge .

2-History of calaber swelling .

Laboratory; 1-Demonstration of microfilaria in blood at

day time. 2-Serological tests .

3-Esinophilia .

Onchocerus volvulus

Tropical Africa ,Sudan , Yemen, Saudi arabia , central America

Habitat- Subcutaneous tissue over bony brominances.

- the dermis, subcutaneous nodules ,all chamber of the eye and they are non periodic

DH ; Man.

IH ; Black flies ,simulium .

Onchocercosis; liver blindness

Cutaneous lesions-Onchocerca nodules.

-severe dermatitis and intense itching over

nodules . -enlarged lymph node in

femoral triangle.

Eye lesions;•- River blindness

•- Keratitis•- Iridocyclitis

•- Blindness•- Degeerative changes

-optic neuritis

Diagnosis; Clinical.

Laboratory; 1 -Direct;

- Microfilaria in ;1-nodules. 2-eye chambers. 3 -cornea.

- Histopathological examination.- Mazzotti test.

2 -Indirect;- Esinophelia20%.

- PCR, serological test.- Intra dermal test ( DIROFILARIA antigen) .

Mansonella PerstansMansonella ozzardi Def;

human filarial nematode, transmitted by tiny blood sucking flies

 called midges.

Disease; Mansonelliasis. serous cavity filariasis.

-asymptomatic.- -angioedema.

- pruritus, Eosinophilia- -fever. -

---headaches .--arthralgias.

--neurologic manifestation.

Central America, caribbean

Diagnosis;-Examination of blood samples for identification of

microfilariae of M. perstans, and M. ozzardi based

This diagnosis can be made on the basis of the morphology of the nuclei distribution in the tails of the microfilariae

Mansonella perstans

Treatment

1 .Di-ethyl-carbamazine citrate; drug of choice. 2mg/kg daily for 2-3 weeks.

2 .Iver mectin; 200-300 ug/kg as single dose repeated after 2 months for4years.

3.Neostibosan; 0.14gm/kg for 5-7 weeks.

4.General treatment;

5 .Surgical treatment .

Pressure bandage

Anti biotics

Prevention and control

Thank you Have a nice

day