Filariasis
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Filarias is Dr. Mejbah Uddin Ahmed
Tissue nematode Classification A) According to habitat: a) Lymphatic system: W. bancrofti, B. malyai, B. timori b) Subcutaneous tissue: D. medinensis, O.volvulus, Loa loa c) Mesentery: D. perstans, M. ozzardi d) Conjunctiva: Loa loa.
Tissue nematode B) According to disease: Disease
Parasite
Lymphatic filariasis
W.bancrofti,B. malyai, timori
Loiasis/ calabar swelling
Loa loa
Onchocerciasis / River blindness
O. volvulus
Dracunculiasis
D. medinensis
B.
Filariasis
Filariasis are a group of parasitic diseases caused by nematodes reside in the lymphatic and connective tissue (W. bancrofti, B. malyai, B. Timori).
Lymphatic filarisis
Lymphatic filarisis is a debilitating and disfiguring chronic disease (lyphoedema, elephantiasis and hydrocele).
Wuchereria bancrofti
Morphological forms: Adult worms Microfilaria
Adult worms: The adult worms are white Females are larger than males and viviparous.
Wuchereria bancrofti
Microfilaria: Average microfilaria measures 240–300 μm in length. A thin delicate sheath surrounds the organism. The head is blunt and round and the tail is pointed. Except the tail tip numerous nuclei are contained in the body.
Wuchereria bancrofti
Periodicity: The microfilarias are not constantly found in the peripheral blood, but show nocturnal periodicity. The exact mechanism is not fully understood. It is determined by species and life style of host and can be altered.
Wuchereria bancrofti
Life cycle:
Definitive host: Man.
Intermediate Host: Mosquito.
Infective form: Microfilaria.
Portal of entry: Skin, by mosquito bite.
Site of localization: Lymphatic system.
Filariasis
Wuchereria bancrofti
Pathology & Clinical feature :
May be asymptomatic
Adult and developing worm causes classical filariasis
Microfilaria causes occult filariasis .
Wuchereria bancrofti
Classical filariasis:
Acute lymphatic filariasis: In the acute form there are recurrent attacks of fever with lymphadenitis and lymphangitis. The lymphatics involved are those of the limbs, genital organs (specially spermatic cord) and breasts.
Filariasis
Causes of lymphangitis: Mechanical irritation, liberation of metabolites, bacterial infection.
Obstruction of lymphatics: Mechanical, excessive fibrosis of lymph vessels and fibrosis of afferent nodes.
Filariasis
Dilatation of lymphatics- Lymphangiovarix.
Rupture of lymphnagiovarix
Lymphorrhgia– Lymphscrotum, Lymphuria Lymphocoele.
Chylorrhagia–Chylocoele, chyluria, chylorrhgia or hematochyluria, chylus diarrhoea, chylus ascitis and chylothorax.
Filariasis
Elephantiasis: Affected part becomes enlarged and tumor like solidity due to hypertrophy & hyperplasia of skin and connective tissues of various parts of the body.
Secondary bacterial infections: Septic lymphangitis, abscess and septicemia.
Elephantiasis
Filariasis
Occult filariasis: The condition when adult worm produces microfilaria continuously but absent in the peripheral blood because they are destroyed in the tissues. This is characterized by massive eosinophilia, hepatosplenomegali, generalized lymphadenopathy & pulmonary symptoms.
Filariasis
Tropical pulmonary eosinophilia: A syndrome of immunological hyper responsiveness of Mf in the lung. It is particularly found in filaria endemic areas. There is a marked eosinophilia, raised ESR and high levels of filarial antibody including high titers of IgE.
Filariasis Laboratory Diagnosis: Sample: Peripheral blood, chylous urine, hydrocele fluid and exudates of lymph varix. Microscopy: Detection of microfilaria stained with Leishman, Giemsa or hematoxylin and eosin stain. Antigen detection: Using an immunoassay for circulating filarial antigens constitutes a useful diagnostic approach.
Filariasis
Molecular diagnosis: Polymerase chain reaction is available for W. bancrofti and B. malayi.
Identification of adult worms: is possible from tissue samples collected from subcutaneous biopsies.
Antibody detection: Is of limited value.
Complement fixation test.
Tissue nematode Classification A) According to habitat: a) Lymphatic system: W. bancrofti, B. malyai, B. timori b) Subcutaneous tissue: D. medinensis, O.volvulus, Loa loa c) Mesentery: D. perstans, M. ozzardi d) Conjunctiva: Loa loa.
Tissue nematode B) According to disease: Disease
Parasite
Lymphatic filariasis
W.bancrofti,B. malyai, timori
Loiasis/ calabar swelling
Loa loa
Onchocerciasis / River blindness
O. volvulus
Dracunculiasis
D. medinensis
B.
Filariasis
Filariasis are a group of parasitic diseases caused by nematodes reside in the lymphatic and connective tissue (W. bancrofti, B. malyai, B. Timori).
Lymphatic filarisis
Lymphatic filarisis is a debilitating and disfiguring chronic disease (lyphoedema, elephantiasis and hydrocele).
Wuchereria bancrofti
Morphological forms: Adult worms Microfilaria
Adult worms: The adult worms are white Females are larger than males and viviparous.
Wuchereria bancrofti
Microfilaria: Average microfilaria measures 240–300 μm in length. A thin delicate sheath surrounds the organism. The head is blunt and round and the tail is pointed. Except the tail tip numerous nuclei are contained in the body.
Wuchereria bancrofti
Periodicity: The microfilarias are not constantly found in the peripheral blood, but show nocturnal periodicity. The exact mechanism is not fully understood. It is determined by species and life style of host and can be altered.
Wuchereria bancrofti
Life cycle:
Definitive host: Man.
Intermediate Host: Mosquito.
Infective form: Microfilaria.
Portal of entry: Skin, by mosquito bite.
Site of localization: Lymphatic system.
Filariasis
Wuchereria bancrofti
Pathology & Clinical feature :
May be asymptomatic
Adult and developing worm causes classical filariasis
Microfilaria causes occult filariasis .
Wuchereria bancrofti
Classical filariasis:
Acute lymphatic filariasis: In the acute form there are recurrent attacks of fever with lymphadenitis and lymphangitis. The lymphatics involved are those of the limbs, genital organs (specially spermatic cord) and breasts.
Filariasis
Causes of lymphangitis: Mechanical irritation, liberation of metabolites, bacterial infection.
Obstruction of lymphatics: Mechanical, excessive fibrosis of lymph vessels and fibrosis of afferent nodes.
Filariasis
Dilatation of lymphatics- Lymphangiovarix.
Rupture of lymphnagiovarix
Lymphorrhgia– Lymphscrotum, Lymphuria Lymphocoele.
Chylorrhagia–Chylocoele, chyluria, chylorrhgia or hematochyluria, chylus diarrhoea, chylus ascitis and chylothorax.
Filariasis
Elephantiasis: Affected part becomes enlarged and tumor like solidity due to hypertrophy & hyperplasia of skin and connective tissues of various parts of the body.
Secondary bacterial infections: Septic lymphangitis, abscess and septicemia.
Elephantiasis
Filariasis
Occult filariasis: The condition when adult worm produces microfilaria continuously but absent in the peripheral blood because they are destroyed in the tissues. This is characterized by massive eosinophilia, hepatosplenomegali, generalized lymphadenopathy & pulmonary symptoms.
Filariasis
Tropical pulmonary eosinophilia: A syndrome of immunological hyper responsiveness of Mf in the lung. It is particularly found in filaria endemic areas. There is a marked eosinophilia, raised ESR and high levels of filarial antibody including high titers of IgE.
Filariasis Laboratory Diagnosis: Sample: Peripheral blood, chylous urine, hydrocele fluid and exudates of lymph varix. Microscopy: Detection of microfilaria stained with Leishman, Giemsa or hematoxylin and eosin stain. Antigen detection: Using an immunoassay for circulating filarial antigens constitutes a useful diagnostic approach.
Filariasis
Molecular diagnosis: Polymerase chain reaction is available for W. bancrofti and B. malayi.
Identification of adult worms: is possible from tissue samples collected from subcutaneous biopsies.
Antibody detection: Is of limited value.
Complement fixation test.
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