Clinical features of filarial

worms
Hemant
Moderator Roll no
33
Dr Mohit Bhatia Batch
 Contents
Clinical features of :-
Loa Loa
Onchocerca Volvulus
Mansonella Species
 Loa Loa
• Calabar swelling or Fugitive swelling
• These are subcutaneous swelling that
develops mainly on extremities
• Develops rapidly in few hours, starts with
pain, pruritus and urticaria
• It lasts for 3-4 days
Calabar swelling in subcutaneous tissue
 Ocular Manifestation
• Conjunctival Granuloma
• Edema of eye lid leading to proptosis

Other rare manifestations

• Nephropathy
• Encephalopathy
• Cardiomyopathy
 Onchocerca Volvulus
Involvement of skin (Dermatitis)
• Intense pruritus and generalized papular rash
• Prolonged infection causing epidermal
atrophy leading to skin wrinkling
• Leopard skin due to repigmentation in
depigmented area
Onchocercoma (subcutaneous nodules)
• Firm, non tender, variable in no and size and
contains adult worms
• African patients-sacrum and hip area
• In patients from South and Central America they
tend to appear more on head and neck
(Courtesy Scott Norton, MD)
 Ocular involvement
• Most serious complication
• Lesions may develop in all parts of eyes
• Conjunctivitis and Photophobia- early
finding
• Sclerosing Keratitis-Leading cause of
Onchocercal blindness in Africa
• Punctate Keratitis- Acute inflammatory
 Lymph nodes involvement
• Lymphadenopathy in inguinal and femoral
areas
• The enlarged nodes may hang down and may
predispose person to hernia
 Mansonella species
Mansonella Perstans – Usually non
Pathogenic but may cause angioedema,
urticaria, pruritus

Mansonella Streptocerca –Infected persons

are asymptomatic, some people develop
inguinal lymphadenopathy and chronic
 Mansonella Ozzardi
Many infected individuals are asymptomatic but
occasionally develop lymphadenopathy,
urticaria, pruritus, pulmonary symptoms,
arthralgia and keratitis
MCQs
Causative agent of calabar
swelling is
A-Loa Loa
B-Onchocerca
C-Mansonella
D-Dirofilaria
A perosn living in sub saharan Africa
came to you with complaints of intense
pruritus and gen papular rash. Initially
he had conjunctivitis but later he lost his
sight. What is the causative agent
responsible for his condition
A-Onchocerca
B-Loa Loa
C-Mansonella
D-Dirofilaria
References
• Essentials of medical parasitology by Apurba
S Sastry
• Clinicalkey.com
• Uptodate.com
Thanks