130 lines
No EOL
43 KiB
XML
130 lines
No EOL
43 KiB
XML
<?xml version="1.0" encoding="utf-8"?>
|
|
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
|
|
<html xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en">
|
|
|
|
<head><meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
|
|
<!-- AppResources meta begin -->
|
|
<meta name="paf-app-resources" content="" />
|
|
<script type="text/javascript">var ncbi_startTime = new Date();</script>
|
|
|
|
<!-- AppResources meta end -->
|
|
|
|
<!-- TemplateResources meta begin -->
|
|
<meta name="paf_template" content="" />
|
|
|
|
<!-- TemplateResources meta end -->
|
|
|
|
<!-- Logger begin -->
|
|
<meta name="ncbi_db" content="books" /><meta name="ncbi_pdid" content="book-part" /><meta name="ncbi_acc" content="NBK547682" /><meta name="ncbi_domain" content="statpearls" /><meta name="ncbi_report" content="printable" /><meta name="ncbi_type" content="fulltext" /><meta name="ncbi_objectid" content="" /><meta name="ncbi_pcid" content="/NBK547682/?report=printable" /><meta name="ncbi_app" content="bookshelf" />
|
|
<!-- Logger end -->
|
|
|
|
<title>Bancroftian Filariasis - StatPearls - NCBI Bookshelf</title>
|
|
|
|
<!-- AppResources external_resources begin -->
|
|
<link rel="stylesheet" href="/core/jig/1.15.2/css/jig.min.css" /><script type="text/javascript" src="/core/jig/1.15.2/js/jig.min.js"></script>
|
|
|
|
<!-- AppResources external_resources end -->
|
|
|
|
<!-- Page meta begin -->
|
|
<meta name="robots" content="INDEX,FOLLOW,NOARCHIVE" /><meta name="citation_inbook_title" content="StatPearls [Internet]" /><meta name="citation_title" content="Bancroftian Filariasis" /><meta name="citation_publisher" content="StatPearls Publishing" /><meta name="citation_date" content="2023/07/31" /><meta name="citation_author" content="Hassam Zulfiqar" /><meta name="citation_author" content="Ahmad Malik" /><meta name="citation_pmid" content="31613462" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK547682/" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Bancroftian Filariasis" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="StatPearls Publishing" /><meta name="DC.Contributor" content="Hassam Zulfiqar" /><meta name="DC.Contributor" content="Ahmad Malik" /><meta name="DC.Date" content="2023/07/31" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK547682/" /><meta name="description" content="Bancroftian filariasis, accounting for 90% of the lymphatic filariasis cases, is one of the most common etiology of acquired lymphedema. It is the second leading infectious cause of disability worldwide after leprosy.[1][2] The disease primarily involves lymphatic system with clinical manifestations ranging from acute, such as acute adenolymphangitis, filarial fever, tropical pulmonary eosinophilia to chronic, such as hydrocele, lymphedema, and elephantiasis in the most severe of cases.[3]" /><meta name="og:title" content="Bancroftian Filariasis" /><meta name="og:type" content="book" /><meta name="og:description" content="Bancroftian filariasis, accounting for 90% of the lymphatic filariasis cases, is one of the most common etiology of acquired lymphedema. It is the second leading infectious cause of disability worldwide after leprosy.[1][2] The disease primarily involves lymphatic system with clinical manifestations ranging from acute, such as acute adenolymphangitis, filarial fever, tropical pulmonary eosinophilia to chronic, such as hydrocele, lymphedema, and elephantiasis in the most severe of cases.[3]" /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK547682/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-statpearls-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="bk-non-canon-loc" content="/books/n/statpearls/article-18128/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK547682/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" /><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} </style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript">window.name="mainwindow";</script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script>
|
|
|
|
<!-- Page meta end -->
|
|
<link rel="shortcut icon" href="//www.ncbi.nlm.nih.gov/favicon.ico" /><meta name="ncbi_phid" content="CE8DA7B87D8899110000000000400039.m_5" />
|
|
<meta name='referrer' content='origin-when-cross-origin'/><link type="text/css" rel="stylesheet" href="//static.pubmed.gov/portal/portal3rc.fcgi/4216699/css/3852956/3985586/3808861/4121862/3974050/3917732/251717/4216701/14534/45193/4113719/3849091/3984811/3751656/4033350/3840896/3577051/3852958/3984801/12930/3964959.css" /><link type="text/css" rel="stylesheet" href="//static.pubmed.gov/portal/portal3rc.fcgi/4216699/css/3411343/3882866.css" media="print" /></head>
|
|
<body class="book-part">
|
|
<div class="grid no_max_width">
|
|
<div class="col twelve_col nomargin shadow">
|
|
<!-- System messages like service outage or JS required; this is handled by the TemplateResources portlet -->
|
|
<div class="sysmessages">
|
|
<noscript>
|
|
<p class="nojs">
|
|
<strong>Warning:</strong>
|
|
The NCBI web site requires JavaScript to function.
|
|
<a href="/guide/browsers/#enablejs" title="Learn how to enable JavaScript" target="_blank">more...</a>
|
|
</p>
|
|
</noscript>
|
|
</div>
|
|
<!--/.sysmessage-->
|
|
<div class="wrap">
|
|
<div class="page">
|
|
<div class="top">
|
|
|
|
<div class="header">
|
|
|
|
|
|
</div>
|
|
|
|
|
|
|
|
<!--<component id="Page" label="headcontent"/>-->
|
|
|
|
</div>
|
|
<div class="content">
|
|
<!-- site messages -->
|
|
<div class="container content">
|
|
<div class="document">
|
|
<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. </p></div></div></div>
|
|
<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK547682_"><span class="title" itemprop="name">Bancroftian Filariasis</span></h1><p class="contrib-group"><h4>Authors</h4><span itemprop="author">Hassam Zulfiqar</span><sup>1</sup>; <span itemprop="author">Ahmad Malik</span><sup>2</sup>.</p><h4>Affiliations</h4><div class="affiliation"><sup>1</sup> Hamad Medical Corporation, Doha, Qatar</div><div class="affiliation"><sup>2</sup> Apex Healthcare</div><p class="small">Last Update: <span itemprop="dateModified">July 31, 2023</span>.</p></div><div class="body-content whole_rhythm" itemprop="text"><div id="article-18128.s1"><h2 id="_article-18128_s1_">Continuing Education Activity</h2><p>Bancroftian filariasis is a leading cause of disability worldwide and a significant public health problem. The chronic sequelae of the disease are crippling. This activity outlines the epidemiology, symptomatology, and management of the ailment and highlights the role of the interprofessional team in coping with the morbidities of the disease and working towards its eradication.</p><p>
|
|
<b>Objectives:</b>
|
|
<ul><li class="half_rhythm"><div>Describe the pathophysiology of bancroftian filariasis.</div></li><li class="half_rhythm"><div>Outline the treatment options available for bancroftian filariasis.</div></li><li class="half_rhythm"><div>Identify the risk associated with initiating diethylcarbamazine therapy in patients with concomitant loiasis.</div></li><li class="half_rhythm"><div>Summarize the importance of collaboration between infectious disease, epidemiologists, surgeons, urologists, and various other clinicians and pharmacists in working towards the goal of eliminating bancroftian filariasis by 2020.</div></li></ul>
|
|
<a href="https://www.statpearls.com/account/trialuserreg/?articleid=18128&utm_source=pubmed&utm_campaign=reviews&utm_content=18128" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Access free multiple choice questions on this topic.</a>
|
|
</p></div><div id="article-18128.s2"><h2 id="_article-18128_s2_">Introduction</h2><p>Bancroftian filariasis, accounting for 90% of the lymphatic filariasis cases, is one of the most common etiology of acquired lymphedema. It is the second leading infectious cause of disability worldwide after leprosy.<a class="bk_pop" href="#article-18128.r1">[1]</a><a class="bk_pop" href="#article-18128.r2">[2]</a> The disease primarily involves lymphatic system with clinical manifestations ranging from acute, such as acute adenolymphangitis, filarial fever, tropical pulmonary eosinophilia to chronic, such as hydrocele, lymphedema, and elephantiasis in the most severe of cases.<a class="bk_pop" href="#article-18128.r3">[3]</a></p><p>In filariasis, there is chronic inflammation of the lymphatics, leading to fibrosis, which eventually leads to lymphedema. While the legs are involved in most cases, the lymphedema can also involve the genitals, arms, and breasts.</p></div><div id="article-18128.s3"><h2 id="_article-18128_s3_">Etiology</h2><p>The causative agent of the disease is the roundworm, <i>Wuchereria bancrofti</i>.<a class="bk_pop" href="#article-18128.r4">[4]</a><a class="bk_pop" href="#article-18128.r5">[5]</a> It multiplies inside human lymphatics releasing immature larvae known as microfilariae into the bloodstream. Mosquitoes ingest these larval forms when they feed on infected human blood and spread the disease to the other people via their bite.<a class="bk_pop" href="#article-18128.r6">[6]</a></p></div><div id="article-18128.s4"><h2 id="_article-18128_s4_">Epidemiology</h2><p>Bancroftian filariasis is a chronic neglected tropical disease endemic in over 72 countries. These endemic regions include South East Asia, Sub Saharan Africa, islands of Pacific, and selected areas in Latin America. An estimated 70 million people in the world suffer from lymphatic filariasis with Wuchereria bancrofti accounting for more than 90% of the cases.<a class="bk_pop" href="#article-18128.r7">[7]</a><a class="bk_pop" href="#article-18128.r8">[8]</a> There are approximately 36 million people worldwide rendered morbidly ill by the disease with up to 25 million people suffering from hydrocele and 15 million from debilitating lymphedema.<a class="bk_pop" href="#article-18128.r9">[9]</a></p><p>The disease holds paramount epidemiological significance as World Health Organization (WHO) plans to eliminate it by 2020.<a class="bk_pop" href="#article-18128.r8">[8]</a><a class="bk_pop" href="#article-18128.r10">[10]</a> This effort will not only prevent unnecessary suffering but also contribute to the reduction of poverty as the expenditure on dealing with the morbidities is enormous.</p></div><div id="article-18128.s5"><h2 id="_article-18128_s5_">Pathophysiology</h2><p>The life cycle of <i>Wuchereria bancrofti</i> is extant in two hosts: man (definitive host) and mosquito (intermediate host). Mosquitoes of the genera <i>Aedes</i>, <i>Anopheles</i>, <i>Culex</i>, and <i>Mansonia</i> ingest microfilariae when they bite humans.<a class="bk_pop" href="#article-18128.r11">[11]</a> The ingested microfilaria travel through the stomach wall into the flight muscles, where they mature into infective larval stages. These infectious form eventually migrate to the proboscis from where they get injected into the human skin during the bite. They then travel through the dermis into the regional lymphatics and further mature into male and female larval forms. Female larvae are responsible for releasing microfilariae into the bloodstream. Microfilariae exhibit circadian periodicity in the peripheral circulation reaching their highest concentration in the blood at night.<a class="bk_pop" href="#article-18128.r6">[6]</a></p><p>The exact mechanism behind the lymphatic damage involves a complex interplay of lymphangiectasia and inflammatory reactions triggered by the dying worms. Adult filarial worms usually reside in the afferent, efferent, and hilar lymphatics, causing blockage and subclinical lymphangiectasia. Moreover, lymphatic damage also results from the host’s immune response to the parasite’s endosymbiont Wolbachia. Antigens released by the dying worms trigger inflammatory reactions causing lymphatic damage.</p><p>Clinical progression of the disease varies in individuals depending on the host’s immune response. Chronicity of the infection has been attributed to the suppression of Th1 and Th2 immune responses. The asymptomatic carrier state has links to the synergistic interplay between poly-specific natural IgG4 and anti-filarial IgG4 in blocking the pathogenesis.<a class="bk_pop" href="#article-18128.r12">[12]</a><a class="bk_pop" href="#article-18128.r13">[13]</a><a class="bk_pop" href="#article-18128.r14">[14]</a> Genetic predisposition to lymphedema and prenatal exposure in endemic areas also play a vital role.</p></div><div id="article-18128.s6"><h2 id="_article-18128_s6_">Histopathology</h2><p>Histopathologic diagnosis is by identifying microfilariae on a peripheral thick smear. Adult forms or eggs may also be seen aiding in the diagnosis. Microscopic examination of an affected tissue usually shows multiple adult filarial worms or microfilaria surrounded by dense eosinophilic infiltration and giant cells. Giemsa staining helps in recognizing microfilarial morphology. The absence or presence of a sheath and the pattern of nuclei in their tail are the key features used to differentiate among various species. Features pathognomonic of <i>Wuchereria bancrofti</i> are i) presence of sheath ii) absence of nuclei in the tail. Other distinctive features include cephalic space length: breadth ratio of 1 to 1, and spherical nuclei which are regularly placed and appear in a regular row, well separated without any overlapping.<a class="bk_pop" href="#article-18128.r15">[15]</a></p></div><div id="article-18128.s7"><h2 id="_article-18128_s7_">History and Physical</h2><p>Individuals can broadly classify into the following clinical categories:</p><ul><li class="half_rhythm"><div>Endemic normals (EN) – subjects living in endemic areas but free of infection and not showing any symptoms of the disease</div></li><li class="half_rhythm"><div>Chronic (CH) – individuals with chronic sequelae of the disease such as elephantiasis, hydrocele or both for more than four years</div></li><li class="half_rhythm"><div>Asymptomatic carriers (AS) – individuals with microfilaremia and antigenemia not showing any clinical symptoms.<a class="bk_pop" href="#article-18128.r14">[14]</a></div></li></ul><p>Clinical manifestations can subdivide into acute and chronic:  </p><p>Acute presentations include:</p><ul><li class="half_rhythm"><div>Acute adenolymphangitis - occurs as a result of the host’s immune response to the antigens released by dying worms - it is characterized by repeated bouts of sudden-onset fever and painful lymphadenopathy. Genitals are commonly involved in males, resulting in painful epididymitis. </div></li><li class="half_rhythm"><div>Filarial fever - characterized by episodes of self-limiting fever without any associated lymphadenopathy.  </div></li><li class="half_rhythm"><div>Tropical pulmonary eosinophilia - characterized by repeated bouts of dry nocturnal cough and wheeze</div></li></ul><p> Chronic presentations include:</p><ul><li class="half_rhythm"><div>Lymphedema - the most common presentation that develops over a long period due to chronic lymphatic damage. It characteristically presents with swelling of the limbs either upper or lower depending on the involvement of inguinal or axillary lymphatic vessels. Pitting edema develops in the early stages of the disease, which later progresses into brawny non-pitting type. Elephantiasis is the most severe type of lymphedema characterized by severe swelling of the limbs, genitalia, and breasts. The skin becomes thick and hard, owing to hyperpigmentation and hyperkeratosis.</div></li><li class="half_rhythm"><div>Hydrocele - this is one of the debilitating morbidities associated with chronic disease. It can be unilateral or bilateral, leading to enlargement of the scrotum. It can be very large, reaching up to 40 cm.</div></li></ul><p>Other manifestations include chyluria, hematuria, inguinal and axillary lymphadenopathy, testicular or inguinal pain, and skin exfoliation.</p></div><div id="article-18128.s8"><h2 id="_article-18128_s8_">Evaluation</h2><p>A detailed inquiry focusing on travel history and establishing the endemicity and chronicity of condition is critical to making a diagnosis. A complete blood count usually shows eosinophilia. Despite recent advances, a nocturnal peripheral thick smear followed by Giemsa staining demonstrating microfilariae in the bloodstream remains the mainstay of diagnosis. Newer methods include circulating filarial antigen test, which has approximately 97% sensitivity and 100% specificity.<a class="bk_pop" href="#article-18128.r16">[16]</a> It is gradually replacing the older nocturnal thick smear test due to its dipstick nature and ability to diagnose the condition in microfilariae-negative patients.<a class="bk_pop" href="#article-18128.r17">[17]</a> Other techniques include membrane filtration method, ultrasonography (filarial dance sign), lymphoscintigraphy, immunochromatographic tests and molecular techniques like in situ hybridization (ISH), fluorescence in situ hybridization (FISH), and polymerase chain reaction (PCR).</p></div><div id="article-18128.s9"><h2 id="_article-18128_s9_">Treatment / Management</h2><p>Diethylcarbamazine (DEC) remains the mainstay of treatment worldwide. Centers for Disease Control and Prevention (CDC) recommends a 1-day or 12-day course of DEC (6 mg/kg/day). Those belonging to onchocerciasis or loiasis co-endemic areas must not be prescribed DEC as it can result in a fatal adverse reaction. Filaricidal action of DEC induces an immunological reaction similar to the Mazzotti reaction seen in onchocerciasis, characterized by headache, joint pain, dizziness, anorexia, malaise, and urticaria. Doxycycline and ivermectin or albendazole is the recommended combination in these individuals. Individuals with chronic disease such as elephantiasis or hydrocele will not benefit from pharmacologic therapy. Surgical treatment may be necessary for those with hydrocele. Patients with lymphedema should be managed by a lymphedema therapist emphasizing the role of basic principles of care such as hygiene, elevation, exercises, skin, and wound care, and wearing appropriate shoes. Steroids, although not widely used, can help in reducing the extent of lymphedema seen in these patients. There is limited evidence for the role of doxycycline as some studies advocate the use of doxycycline (200mg/day for 4 to 6 weeks) in adult worm killing and preventing the progression of lymphedema. Suramin is widely used in onchocerciasis, yet its role remains uncertain in lymphatic filariasis.</p></div><div id="article-18128.s10"><h2 id="_article-18128_s10_">Differential Diagnosis</h2><p>Bancroftian filariasis is only one cause of lymphatic filariasis. Other conditions involving the lymphatic system can also mimic the disease. It is important to consider age, travel history, family history, endemicity, and socioeconomic status when trying to work out a diagnosis.</p><p>The differentials include:</p><ul><li class="half_rhythm"><div>
|
|
<i>Brugia malayi</i>
|
|
</div></li><li class="half_rhythm"><div>
|
|
<i>Brugia timori</i>
|
|
</div></li><li class="half_rhythm"><div>Sporotrichosis</div></li><li class="half_rhythm"><div>Lymphosarcoma</div></li><li class="half_rhythm"><div>Carcinoma of testis or scrotum</div></li><li class="half_rhythm"><div>Congenital hydrocele</div></li><li class="half_rhythm"><div>Epidydimal cysts</div></li><li class="half_rhythm"><div>Milroy syndrome</div></li><li class="half_rhythm"><div>Bacterial lymphadenitis</div></li></ul></div><div id="article-18128.s11"><h2 id="_article-18128_s11_">Prognosis</h2><p>The response to diethylcarbamazine is excellent for acute forms of the disease. However, those having chronic lymphatic damage in the form of lymphedema or elephantiasis will respond poorly. These chronic forms have a poor prognosis. Patients with hydrocele might respond to surgery, but recurrence is common. The condition is debilitating rendering the person incapable of performing daily activities.</p></div><div id="article-18128.s12"><h2 id="_article-18128_s12_">Complications</h2><p>The grimmest complication of the disease is elephantiasis seen in individuals with long-standing filarial infection. Other complications include hydrocele and adverse reactions from DEC therapy such as encephalopathy and even death when used in loiasis-endemic areas.</p></div><div id="article-18128.s13"><h2 id="_article-18128_s13_">Consultations</h2><p>Patients with a high index of suspicion for bancroftian filariasis require immediate consultation from infectious diseases expert. General surgery/urology consultation is helpful when dealing with hydrocele. If the patient is in the United States, one should contact the CDC.</p></div><div id="article-18128.s14"><h2 id="_article-18128_s14_">Deterrence and Patient Education</h2><p>Avoiding mosquito bites and enforcing vector control measures is crucial to avoid contracting the disease. Tourist should avoid visiting endemic areas. Visitors touring endemic areas should sleep under mosquito nets, wear long sleeves and trousers, and use mosquito repellent on exposed parts of the body. There is currently no vaccine available. Individuals with lymphedema should maintain good personal hygiene and wash affected areas with antiseptic solution daily. Compression stockings, regular exercise, and using a pillow beneath the affected limb at night can help in reducing the swelling. Restricting a fatty diet is extremely important in patients with overt chyluria. Moreover, a high protein diet and foods rich in high medium-chain triglycerides content are recommended patients having chyluria.</p></div><div id="article-18128.s15"><h2 id="_article-18128_s15_">Pearls and Other Issues</h2><ul><li class="half_rhythm"><div>Bancroftian filariasis is a mosquito-borne disease caused by the nematode <i>Wuchereria bancrofti</i>.</div></li><li class="half_rhythm"><div>The disease is the second most common cause of disability worldwide after leprosy.</div></li><li class="half_rhythm"><div>WHO is to target the elimination of the disease by 2020.</div></li><li class="half_rhythm"><div>Elephantiasis is the most debilitating complication of the disease</div></li><li class="half_rhythm"><div>A nocturnal peripheral thick smear showing microfilariae is diagnostic of the disease.</div></li><li class="half_rhythm"><div>Diethylcarbamazine is the mainstay of treatment worldwide.</div></li><li class="half_rhythm"><div>Diethylcarbamazine is not for use in patients having concomitant loiasis.</div></li></ul></div><div id="article-18128.s16"><h2 id="_article-18128_s16_">Enhancing Healthcare Team Outcomes </h2><p>Bancroftian filariasis is one of the neglected tropical diseases and is unlikely to be seen in the US. However, clinicians must have a high index of suspicion whenever dealing with immigrants or travelers from endemic areas presenting with limb swelling, hydrocele, lymphadenopathy, or chyluria. Travelers to the tropic should receive education regarding mosquito bite prevention. Since it is a mosquito-borne disease, prevention involves taking vector control measures such as mosquito nets, applying mosquito repellents, wearing trousers and long-sleeved clothes, and reduction of peri-domiciliary water puddles. The two major public health strategies being employed to eliminate the disease include a) mass drug administration (MDA) to reduce the microfilarial density to suboptimal levels for vector transmission b) ensuring the provision of recommended basic package of care in endemic areas to alleviate the suffering caused by the disease.<a class="bk_pop" href="#article-18128.r7">[7]</a><a class="bk_pop" href="#article-18128.r8">[8]</a><a class="bk_pop" href="#article-18128.r9">[9]</a><a class="bk_pop" href="#article-18128.r18">[18]</a></p><p>Upon starting treatment in non-surgical cases, the pharmacist (potentially with a specialty in infectious disease) should educate the patient on compliance with treatment and the need for follow up, as well as verifying dosing and checking for drug interactions. Often most symptoms take months to subside, but disability is rare if the patient completes the treatment course. The lymphedema may decrease but may not completely resolve, and hence the patient must be told to wear compression garments for life. Nursing can provide ongoing education and monitoring, verify treatment compliance, and alert the treating clinician of any issues. For surgical cases, the nursing staff will be involved pre, during, and postoperatively, providing preparation assistance, and postoperative care, and keeping the surgeon informed following the procedure. Even in light of the rarity of this disease, an interprofessional team approach to care is necessary to achieve optimal results for the patient. [Level V]</p></div><div id="article-18128.s17"><h2 id="_article-18128_s17_">Review Questions</h2><ul><li class="half_rhythm"><div>
|
|
<a href="https://www.statpearls.com/account/trialuserreg/?articleid=18128&utm_source=pubmed&utm_campaign=reviews&utm_content=18128" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Access free multiple choice questions on this topic.</a>
|
|
</div></li><li class="half_rhythm"><div>
|
|
<a href="https://mdsearchlight.com/infectious-disease/bancroftian-filariasis/?utm_source=pubmedlink&utm_campaign=MDS&utm_content=18128" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Click here for a simplified version.</a>
|
|
</div></li><li class="half_rhythm"><div>
|
|
<a href="https://www.statpearls.com/articlelibrary/commentarticle/18128/?utm_source=pubmed&utm_campaign=comments&utm_content=18128" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Comment on this article.</a>
|
|
</div></li></ul></div><div class="floats-group" id="article-18128.s18"></div><div class="floats-group" id="article-18128.s19"></div><div id="article-18128.s20"><h2 id="_article-18128_s20_">References</h2><dl class="temp-labeled-list"><dt>1.</dt><dd><div class="bk_ref" id="article-18128.r1">Maldjian C, Khanna V, Tandon B, Then M, Yassin M, Adam R, Klein MJ. Lymphatic filariasis disseminating to the upper extremity. <span><span class="ref-journal">Case Rep Radiol. </span>2014;<span class="ref-vol">2014</span>:985680.</span> [<a href="/pmc/articles/PMC3965918/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3965918</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24707427" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24707427</span></a>]</div></dd><dt>2.</dt><dd><div class="bk_ref" id="article-18128.r2">Pryce J, Mableson HE, Choudhary R, Pandey BD, Aley D, Betts H, Mackenzie CD, Kelly-Hope LA, Cross H. Assessing the feasibility of integration of self-care for filarial lymphoedema into existing community leprosy self-help groups in Nepal. <span><span class="ref-journal">BMC Public Health. </span>2018 Jan 30;<span class="ref-vol">18</span>(1):201.</span> [<a href="/pmc/articles/PMC5791211/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5791211</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29382314" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29382314</span></a>]</div></dd><dt>3.</dt><dd><div class="bk_ref" id="article-18128.r3">Chandy A, Thakur AS, Singh MP, Manigauha A. A review of neglected tropical diseases: filariasis. <span><span class="ref-journal">Asian Pac J Trop Med. </span>2011 Jul;<span class="ref-vol">4</span>(7):581-6.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/21803313" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21803313</span></a>]</div></dd><dt>4.</dt><dd><div class="bk_ref" id="article-18128.r4">Katiyar D, Singh LK. Filariasis: Current status, treatment and recent advances in drug development. <span><span class="ref-journal">Curr Med Chem. </span>2011;<span class="ref-vol">18</span>(14):2174-85.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/21521163" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21521163</span></a>]</div></dd><dt>5.</dt><dd><div class="bk_ref" id="article-18128.r5">Famakinde DO. Mosquitoes and the Lymphatic Filarial Parasites: Research Trends and Budding Roadmaps to Future Disease Eradication. <span><span class="ref-journal">Trop Med Infect Dis. </span>2018 Jan 04;<span class="ref-vol">3</span>(1)</span> [<a href="/pmc/articles/PMC6136629/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6136629</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30274403" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30274403</span></a>]</div></dd><dt>6.</dt><dd><div class="bk_ref" id="article-18128.r6">Paily KP, Hoti SL, Das PK. A review of the complexity of biology of lymphatic filarial parasites. <span><span class="ref-journal">J Parasit Dis. </span>2009 Dec;<span class="ref-vol">33</span>(1-2):3-12.</span> [<a href="/pmc/articles/PMC3454129/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3454129</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23129882" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23129882</span></a>]</div></dd><dt>7.</dt><dd><div class="bk_ref" id="article-18128.r7">Summary of global update on preventive chemotherapy implementation in 2016: crossing the billion. <span><span class="ref-journal">Wkly Epidemiol Rec. </span>2017 Oct 06;<span class="ref-vol">92</span>(40):589-93.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/28984120" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28984120</span></a>]</div></dd><dt>8.</dt><dd><div class="bk_ref" id="article-18128.r8">Small ST, Ramesh A, Bun K, Reimer L, Thomsen E, Baea M, Bockarie MJ, Siba P, Kazura JW, Tisch DJ, Zimmerman PA. Population genetics of the filarial worm wuchereria bancrofti in a post-treatment region of Papua New Guinea: insights into diversity and life history. <span><span class="ref-journal">PLoS Negl Trop Dis. </span>2013;<span class="ref-vol">7</span>(7):e2308.</span> [<a href="/pmc/articles/PMC3708868/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3708868</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23875043" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23875043</span></a>]</div></dd><dt>9.</dt><dd><div class="bk_ref" id="article-18128.r9">Adhikari RK, Sherchand JB, Mishra SR, Ranabhat K, Pokharel A, Devkota P, Mishra D, Ghimire YC, Gelal K, Paudel R, Wagle RR. Health-seeking behaviors and self-care practices of people with filarial lymphoedema in Nepal: a qualitative study. <span><span class="ref-journal">J Trop Med. </span>2015;<span class="ref-vol">2015</span>:260359.</span> [<a href="/pmc/articles/PMC4324917/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4324917</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25694785" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25694785</span></a>]</div></dd><dt>10.</dt><dd><div class="bk_ref" id="article-18128.r10">Ichimori K, King JD, Engels D, Yajima A, Mikhailov A, Lammie P, Ottesen EA. Global programme to eliminate lymphatic filariasis: the processes underlying programme success. <span><span class="ref-journal">PLoS Negl Trop Dis. </span>2014 Dec;<span class="ref-vol">8</span>(12):e3328.</span> [<a href="/pmc/articles/PMC4263400/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4263400</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25502758" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25502758</span></a>]</div></dd><dt>11.</dt><dd><div class="bk_ref" id="article-18128.r11">Erickson SM, Thomsen EK, Keven JB, Vincent N, Koimbu G, Siba PM, Christensen BM, Reimer LJ. Mosquito-parasite interactions can shape filariasis transmission dynamics and impact elimination programs. <span><span class="ref-journal">PLoS Negl Trop Dis. </span>2013;<span class="ref-vol">7</span>(9):e2433.</span> [<a href="/pmc/articles/PMC3772046/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3772046</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24069488" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24069488</span></a>]</div></dd><dt>12.</dt><dd><div class="bk_ref" id="article-18128.r12">Nutman TB. Insights into the pathogenesis of disease in human lymphatic filariasis. <span><span class="ref-journal">Lymphat Res Biol. </span>2013 Sep;<span class="ref-vol">11</span>(3):144-8.</span> [<a href="/pmc/articles/PMC3780283/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3780283</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24044755" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24044755</span></a>]</div></dd><dt>13.</dt><dd><div class="bk_ref" id="article-18128.r13">Babu S, Nutman TB. Immunopathogenesis of lymphatic filarial disease. <span><span class="ref-journal">Semin Immunopathol. </span>2012 Nov;<span class="ref-vol">34</span>(6):847-61.</span> [<a href="/pmc/articles/PMC3498535/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3498535</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23053393" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23053393</span></a>]</div></dd><dt>14.</dt><dd><div class="bk_ref" id="article-18128.r14">Mishra R, Panda SK, Sahoo PK, Mishra S, Satapathy AK. Self-reactive IgG4 antibodies are associated with blocking of pathology in human lymphatic filariasis. <span><span class="ref-journal">Cell Immunol. </span>2019 Jul;<span class="ref-vol">341</span>:103927.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/31130239" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31130239</span></a>]</div></dd><dt>15.</dt><dd><div class="bk_ref" id="article-18128.r15">Pandey P, Dixit A, Chandra S, Tanwar A. Cytological diagnosis of bancroftian filariasis presented as a subcutaneous swelling in the cubital fossa: an unusual presentation. <span><span class="ref-journal">Oxf Med Case Reports. </span>2015 Apr;<span class="ref-vol">2015</span>(4):251-3.</span> [<a href="/pmc/articles/PMC4664843/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4664843</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26634138" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26634138</span></a>]</div></dd><dt>16.</dt><dd><div class="bk_ref" id="article-18128.r16">El-Moamly AA, El-Sweify MA, Hafez MA. Using the AD12-ICT rapid-format test to detect Wuchereria bancrofti circulating antigens in comparison to Og4C3-ELISA and nucleopore membrane filtration and microscopy techniques. <span><span class="ref-journal">Parasitol Res. </span>2012 Sep;<span class="ref-vol">111</span>(3):1379-83.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/22392137" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22392137</span></a>]</div></dd><dt>17.</dt><dd><div class="bk_ref" id="article-18128.r17">Tripathi PK, Mahajan RC, Malla N, Mewara A, Bhattacharya SM, Shenoy RK, Sehgal R. Circulating filarial antigen detection in brugian filariasis. <span><span class="ref-journal">Parasitology. </span>2016 Mar;<span class="ref-vol">143</span>(3):350-7.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/26646772" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26646772</span></a>]</div></dd><dt>18.</dt><dd><div class="bk_ref" id="article-18128.r18">Specht S, Suma TK, Pedrique B, Hoerauf A. Elimination of lymphatic filariasis in South East Asia. <span><span class="ref-journal">BMJ. </span>2019 Jan 22;<span class="ref-vol">364</span>:k5198.</span> [<a href="/pmc/articles/PMC6340355/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6340355</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30670373" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30670373</span></a>]</div></dd></dl></div><div><dl class="temp-labeled-list small"><dt></dt><dd><div><p class="no_top_margin">
|
|
<b>Disclosure: </b>Hassam Zulfiqar declares no relevant financial relationships with ineligible companies.</p></div></dd><dt></dt><dd><div><p class="no_top_margin">
|
|
<b>Disclosure: </b>Ahmad Malik declares no relevant financial relationships with ineligible companies.</p></div></dd></dl></div><div class="bk_prnt_sctn"><h2>Figures</h2><div class="whole_rhythm bk_prnt_obj bk_first_prnt_obj"><div id="article-18128.image.f1" class="figure bk_fig"><div class="graphic"><img src="/books/NBK547682/bin/Wuchereria_bancrofti_1_DPDX.jpg" alt="Wuchereria bancrofti Contributed From the Center of Disease Control and Prevention (CDC; Public Domain) Image courtesy: https://en" /></div><div class="caption"><p>Wuchereria bancrofti Contributed From the Center of Disease Control and Prevention (CDC; Public Domain)
|
|
Image courtesy: https://en.wikipedia.org/wiki/Wuchereria_bancrofti#/media/File:Wuchereria_bancrofti_1_DPDX.JPG</p></div></div></div><div class="whole_rhythm bk_prnt_obj"><div id="article-18128.image.f2" class="figure bk_fig"><div class="graphic"><img src="/books/NBK547682/bin/W_bancrofti_LifeCycle.jpg" alt="W" /></div><div class="caption"><p>W.Bancrofti lifecycle Contributed by the Centers for Disease Control and Prevention (CDC Public Domain)</p></div></div></div></div></div></div>
|
|
<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © 2025, StatPearls Publishing LLC.<p class="small">
|
|
This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
|
|
(<a href="https://creativecommons.org/licenses/by-nc-nd/4.0/" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=uri">
|
|
http://creativecommons.org/licenses/by-nc-nd/4.0/
|
|
</a>), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.
|
|
</p></div><div class="small"><span class="label">Bookshelf ID: NBK547682</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/31613462" title="PubMed record of this page" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">31613462</a></span></div></div></div>
|
|
|
|
</div>
|
|
</div>
|
|
</div>
|
|
<div class="bottom">
|
|
|
|
<div id="NCBIFooter_dynamic">
|
|
<!--<component id="Breadcrumbs" label="breadcrumbs"/>
|
|
<component id="Breadcrumbs" label="helpdesk"/>-->
|
|
|
|
</div>
|
|
|
|
<script type="text/javascript" src="/portal/portal3rc.fcgi/rlib/js/InstrumentNCBIBaseJS/InstrumentPageStarterJS.js"> </script>
|
|
</div>
|
|
</div>
|
|
<!--/.page-->
|
|
</div>
|
|
<!--/.wrap-->
|
|
</div><!-- /.twelve_col -->
|
|
</div>
|
|
<!-- /.grid -->
|
|
|
|
<span class="PAFAppResources"></span>
|
|
|
|
<!-- BESelector tab -->
|
|
|
|
|
|
|
|
<noscript><img alt="statistics" src="/stat?jsdisabled=true&ncbi_db=books&ncbi_pdid=book-part&ncbi_acc=NBK547682&ncbi_domain=statpearls&ncbi_report=printable&ncbi_type=fulltext&ncbi_objectid=&ncbi_pcid=/NBK547682/?report=printable&ncbi_app=bookshelf" /></noscript>
|
|
|
|
|
|
<!-- usually for JS scripts at page bottom -->
|
|
<!--<component id="PageFixtures" label="styles"></component>-->
|
|
|
|
|
|
<!-- CE8B5AF87C7FFCB1_0191SID /projects/books/PBooks@9.11 portal106 v4.1.r689238 Tue, Oct 22 2024 16:10:51 -->
|
|
<span id="portal-csrf-token" style="display:none" data-token="CE8B5AF87C7FFCB1_0191SID"></span>
|
|
|
|
<script type="text/javascript" src="//static.pubmed.gov/portal/portal3rc.fcgi/4216699/js/3879255/4121861/3501987/4008961/3893018/3821238/3400083/3426610.js" snapshot="books"></script></body>
|
|
</html> |