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Filariasis: Signs and symptoms

Filariasis is a disease caused by a chronic mosquito-borne parasitic infection. Chronic infection can lead to swelling of the extremities, hydroceles, and testicular masses. It is the second-largest cause of permanent deformity and disability behind leprosy worldwide.

Infection caused by parasites classified as nematodes: Lymphatic filariasis is caused by infection with parasites classified as nematodes (roundworms) of the family Filariodidea. There are 3 types of these thread-like filarial worms: Wuchereria bancrofti, which is responsible for 90% of the cases.

Detected by examining thick smears: Filariasis circulating microfilariae can be detected by examining thick smears (20–60 μl) of finger-prick blood. Blood must be collected at a specific time – either at night or during the day – depending on the periodicity of the microfilariae.

Signs and symptoms :


Inguinal or axillary lymphadenopathy.

Testicular and/or inguinal pain.

Skin exfoliation.

Limb or genital swelling - Repeated episodes of inflammation and lymphedema lead to lymphatic damage, chronic swelling, and elephantiasis of the legs, arms, scrotum, vulva, and breasts

Even pain in the upper arm side is manifest.

Even the slightest suspicion of filariasis in an endemic area, straight away start Hetrazan.... otherwise it may be too late and elephantiasis may result... in arms or legs which are incurable. Mangalore was an endemic area with cases still happening.

Precaution: Prevent mosquito bites by spraying yourselves with a strong deodorant.

What time is the filaria test?

Test Code FIL Filaria, Blood

For the agents of lymphatic filariasis (Wuchereria bancrofti and the Brugia species), blood should be collected between 10 p.m. and 2 a.m., whereas for detection of Loa loa, blood should be collected between 10 a.m. and 2 p.m.

Patients with active filarial infection typically have elevated levels of antifilarial IgG4 in the blood and these can be detected using routine assays.

Test recommended for mapping: The Alere Filariasis Test Strip (FTS) is a rapid diagnostic test recommended for mapping, monitoring and transmission assessment surveys (TAS) for the qualitative detection of Wuchereria bancrofti antigen in human blood samples. The FTS has replaced the Binax Now filariasis test.

Acute attacks

The adult filarial worms cause inflammation of the lymphatic system, resulting in lymphangitis and lymphadenitis. These conditions lead to lymphatic vessel damage, even in asymptomatic people, and lymphatic dysfunction, which predisposes the lower limbs in particular to recurrent bacterial infection. These secondary infections provoke adenolymphangitis (ADL), commonly called “acute attacks”, which are the commonest symptom of lymphatic filariasis and play an important role in the progression of lymphoedema. It has been suggested that bacteria commonly gain access to damaged lymphatic vessels through “entry lesions”, often between the toes. ADL, which resembles erysipelas or cellulitis, is associated with local pain and swelling and with fever and chills.

Lymphoedema and elephantiasis: Lymphoedema and its more advanced form, elephantiasis, occur primarily in the lower limbs and are commoner in women. Several factors have been implicated in the progression of lymphoedema, including repeated episodes of ADL

Hydrocoele: Scrotal hydrocoele is due to the accumulation of fluid in the cavity of the tunica vaginalis. It has been suggested that true filarial hydrocoele occurs after the death of adult filarial worms, while a chylocoele is due to the accumulation of fluid after the rupture of lymphatic vessels in the scrotal cavity.

A single dose of a combination of albendazole (400 mg) plus diethylcarbamazine (6 mg/kg)...21 days ( Hetrazan 100mg thrice a day. 21 days)

Once lymph channels are destroyed by microfilaria, it is irreparable. Under any circumstance, AVOID mosquito bites.

Based on the research, bestatin (also known as ubenimex), is being tested in a clinical trial that started in May 2016 — known as ULTRA — as a treatment for secondary lymphedema, which occurs because of damage to the lymphatic system from surgery, radiation therapy, trauma or infection.

Inputs courtesy: ENT specialist with 41 years of experience, who prefers to remain anonymous.

-Manohar Yadavatti


  1. Krishna Itnal pune very good coverage of facts.Congratulations.


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