Every thing you want to know about Filariasis(Elephantiasis)

Filariasis(Elephantiasis)

-parasitic disease caused by an African eye worm, a microscopic thread-like worm.

- The adult worm can only live in human lymphatic system.

- Can cause extensive disability and gross disfigurement.

Causative Organism

Wuchereria bancrofti is the causative agent of filariasis.

- 4 to 5 cm long thread-like worm that affects the body’s lymph nodes and lymph vessels.

Mode of Transmission –  by mosquito bite.

Pathology/Pathogenesis

1. When a mosquito bites a person with lymphatic filariasis, microscopic worms circulating in the person’s blood enter and infect the mosquito.

2. The microscopic worms pass from the mosquito through the human skin and travel to the lymph vessels where they grow into adults.

3. An adult worm lives for 7 years in the lymph vessels. They mate and release into the bloodstream millions of microscopic worms known as microfilaria.

4. Once the person has the worms in his or her blood, these are picked up by the biting mosquito when it feeds and the disease is transmitted to another person via the larvae.

5. The larvae migrate to the lymph nodes, reach sexual maturity, and the cycle is completed.

6. A person needs many mosquito bites over several months to years to get Filariasis.

7. At first, most people do not know they have Filariasis.

8. The disease damages the kidneys and the lymph system; fluid collects and causes swelling in the arms, breasts, legs and for men, the genital area.

9. The entire leg, arms, and genital area may swell to several times their normal sizes.

10. In advanced stages, the worms can actually obstruct the vessels, causing the surrounding tissues to enlarge.

Symptoms

·         Chills, headache & fever between 3 months and 1 year after the insect bite.

·         Swelling, redness & pain in the arms, legs or scrotum.

·         Areas of abscesses

Diagnostic Procdures

·          Circulating Filarial Antigen (CFA) test is performed on a finger-prick blood droplet taken any time of the day and gives result in a few minutes.

·          The larvae can also be found in the blood, but mosquitoes which spread the disease are active at night, the larvae are usually found between about 10:00 pm to 2:00 am.

·          Patient’s history must be taken and pattern of inflammation and signs of lymphatic obstruction must be observed.

Modalities of Treatment

1. Ivermectin. Albendazole, or diethylcarbamazine (DEC) are used to treat by:

a.       eliminating the larvae

b.      impairing the adult worm’s ability to reproduce

c.       by actually killing the adult worms

2. Surgery – to remove surplus tissue & provide a way to drain the fluid around the damaged lymphatic vessels.

3. Elevate the legs and providing support with elastic bandages.

Fungal Infections

·         Tinea Flava (Tinea alba/Tinea versicolor)

- common, benign, superficial, cutaneous fungal infection, characterized by hypopigmentation or hyperpigmentation on the skin usually at the back or on the

chest.

Etiologic Agent: lipophilic fungi (Malassezia furfur)

Incidence

·         The disease affects young people around the puberty age due to hormonal changes & increase in cebum secretion.

·         Both male & female can equally be affected.

·         Tropical areas can have a prevalence as high as 40%.

Clinical Manifestation

1. Has cosmetically disturbing, abnormal pigmentation

2. Color of lesion varies from almost white to reddish brown or fawn colored.

3. A fine, dust-like scale covers the lesions.

4. Patient complains of mild pruritus.

Treatment Modalities

·         Topical agents include:

-          Micoconazole

-          Ciclopirox colamine

-          Propylene glycol lotion

-          Topical terbinafine

-          Benzoyl peroxide

Nursing Management

1. Instruct patient to use clean towel and washcloth daily.

2. All skin areas and skin folds that retain the moisture must be dried thoroughly.

3. Clean cotton clothing should be worn next to the skin.