ACUTE FILARIASIS
The Acute clinical manifestations of lymphatic filariasis are characterized by episodic attacks
of lymphadenitis and lymphangitis associated with fever and malaise.Sometimes fever precedes the adenolymphangitis
by a few days.Although the fever sometimes precedes adenolymphangitis, fever alone, in the absence of adenolymphangitis, should not
be ascribed to filariasis, even when microfilaraemia is present.
The main clinical manifestations of acute filariasis are:
FILARIAL FEVER
Filarial fever is an acute recurrent fever with haedache, malaise, chills, rigors, low to high grade (38-40°),subsiding with sweating
and it may closely resemble
malaria.Fever persists for 3-5 days. It is usually accompanied by symptomatic lymphangitis and other
early signs of filariasis but may occur as fever alone.
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LYMPHANGITIS AND LYMPHADENITIS
Acute lymphadenitis and lymphangitis are characteristic of Bancroftian and Malayan filariasis.
The onset is acute, involving a single
gland or group of glands within the inguinal, axillary, cervical or epitrochlear regions.
This is accompanied by fever; 6-8 hours later retrograde (centrifugal) lymphangitis starts
in the glands and spreads peripherally.
The
lymphatic trunks become painful and cord-like with characteristic red streaks running down the
arms or legs. The distal affected limb
becomes swollen and oedematous during the attack which may continue for several days
accompanied by the fever.
Lymphangitis may be confined to the
groin glands, testis, spermatic cord (endemic funiculitis) or abdominal varix ruptures,
symptoms of peritonitis rapidly develop and may be fatal (abdominal filariais)
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This is an acute painful inflammation of the spermatic cord and epididymis. This is usually
associated with fever and inflammation of testis and painful glands in the groins.
Lymphangitis of the spermatic cord gives rise to funiculitis which has been
called 'endemic funiculitis'.It is usually accompanied by filarial fever and orchitis.
Fluid aspirated from the runica vaginalis is cloudy and contains a number of
polymorphonuclear cells and occasional red cells, together with microfilariae.
The acute symptoms last a few days but recur at intervals. In sections dead and
efferentia causing extensive fibrotic change are found and it is possible,
although not yet proved, that this may result in sterility. The end result
is a thickened spermatic cord.
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EPIDIDYMO-ORCHITIS
Epididymo-orchitis is an acute painful condition involving the testis and epididymis
resulting in some degree of scrotal swelling and redness.
It is usually associated with fever, funiculitis and lymphnode elargement in the
groin.
The onset is sudden with pain radiating to the groin and tendernesss
of the testis which may swell to twice its usual size with a boggy feeling
on palpation.
Orchitis is associated with filarial fever,and recurrent attacks
lead sooner or later to hydrocele.
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FILARIAL ABSCESS
Filarial abscesses develop within superficial lymphatics on the limbs or scrotum and at first
the symptoms resemble an attack of lymphangitis but the pain and swelling continue, to be
followed after some weeks by rupture and a discharge of pus. Pus may be sterile or contain
bacteria particularly Beta haemolytic streptococci. Fragments of dead adult worms may be discharged. |  |
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