What is Lymphatic Filariasis, Know its Causes, Symptoms, Treatment, Diagnosis
Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA
What is Lymphatic Filariasis?
Lymphatic filariasis is medically described as an infection that affects the lymphatic circulation, lymph nodes and lymphatic vessels. This infection is caused due to a threadworm called Wuchereria Bancrofti, which is transmitted form one person to another via mosquito bites. These larval worms easily circulate through your bloodstream and gradually grow up within the lymph nodes. This causes obstruction in circulation and leads to a medical condition known as lymphatic filariasis, which is characterized by swelling of limbs and testicles. It is important to know the causes, symptoms and treatment of lymphatic filariasis to treat and prevent this condition.
There are drugs available for treatment of lymphatic filariasis. The treatment basically focuses on killing the parasitic worms in body and additional therapy is prescribed to cope up with the swelling of the limbs. In some severe cases, surgical procedures are prescribed to treat the lymphatic obstruction.
Causes of Lymphatic Filariasis
As already mentioned, the main cause of lymphatic filariasis is a parasitic threadworm called Wuchereria Bancrofti. These worms are basically transmitted from infected people to uninfected people through mosquito bites. Different species of mosquito are responsible for transmitting the worms from an infected individual to an uninfected individual.
The adult worm is smooth, thick and rounded on both the ends. These adult worms get transmitted to the body and produce their offspring called microfilariae, which circulate into the bloodstream, while the adult worms remain in the lymphatic system. The mosquito bites an infected individual and transmits the produced microfilariae to uninfected people. Again the microfilariae mature in the lymphatic system into adult and this cycle goes on. This is the only cause of lymphatic filariasis, in people.
Symptoms of Lymphatic Filariasis
The symptoms of lymphatic filariasis are variable and depend a lot on a person’s health condition. It is not necessary that everyone in the endemic area is at the risk of developing such infection and have symptoms. Some infected people sometimes recover without any such symptoms of lymphatic filariasis. The symptoms also vary from one infected person to another and it is essential to recognize the symptoms carefully to get the right treatment at the right time. The symptoms of this infection can be chronic or acute.
Some of the symptoms of lymphatic filariasis are given here.
- Recurrent episodes of chills and fever can be a symptom of lymphatic filariasis. Very high fever with chills during daytime and at night, especially when the microfilariae circulates across the bloodstream.
- Swelling and inflammation of lymph nodes leading to redness, pain and tenderness in the lymph nodes.
- Symptoms of Lymphatic Filariasis may include swelling in penis, hands, legs and testis in male counterparts and this actually happens when there is fluid accumulated in testis which causes a condition called hydrocele. Females may have larger or swollen breast and this occurs when the free flow of lymph fluid through the lymphatics is obstructed by the adult worms in their body.
- In some cases, the lymphatic filariasis patients may also have symptoms of swelling on genitals, legs and arms, known as elephantiasis, which is one of the characteristic symptoms of lymphatic filariasis.
- Some people may also have paroxysmal coughing at night. It is just like the cough that most of the asthmatic patients have. This is actually the allergic reaction that occurs when the microfilariae travel through the bloodstream to the lungs.
- Passing white urine, which is termed as chyluria is another typical symptom of lymphatic filariasis. It can lead to loss of crucial nutrients from the body, thereby leading to emaciation and weight loss.
- Thickening of leg skin and hand skin is sometimes noted in lymphatic filariasis, especially in chronic cases.
Diagnosis of lymphatic filariasis is done on the basis of symptoms, clinical examinations and investigations to confirm the infection of Wuchereria Bancrofti.
- Full body test is performed to know their full medical history
- Blood tests are performed to find if larval worms are present in the bloodstream
- The presence of microfilariae can be detected only by testing the lymphatic fluid and blood. The tests are done around 10pm and 2am when the microfilariae are fully active in the bloodstream.
- The serum of patients are also tested to find out the anti-filarial antibodies
- Ultrasound scan may also be prescribed to observe if adult worms are present in the lymphatic vessels or lymph nodes.
If all these methods fail to find the presence of microfilariae in blood, then the healthcare professional will use other techniques to test the protein produced by the adult Wuchereria Bancrofti in body. These tests are commonly referred as circulating filarial antigen or CFA Test. These specialized tests can confirm the diagnosis of lymphatic filariasis.
Treatment of Lymphatic Filariasis
Based on the test and symptoms, the healthcare professionals will prescribe effective treatment of lymphatic filariasis. There are different treatment options available for this infection and the most suitable one needs to be chosen.
- The primary drug that is prescribed to treat the infection is DEC or diethylcarbamazine. This drug focuses on killing the microfilariae which are active and circulating through the bloodstream. This drug is effective against the adult Wuchereria Bancrofti worms and can effectively treat lymphatic filariasis.
- In cases where the lymph nodes are severely clogged and limbs are inflamed, the healthcare professionals may prescribe surgical procedures to reduce the swelling and relieve the obstruction.
- Treatment of lymphatic filariasis also includes prescription of pain medication and antihistamines to help patients alleviate pain and other allergic symptoms of lymphatic filariasis.
- Treatment of larger hydrocele may be critical and may require surgical intervention to pass out the accumulated fluid.
- Effective steps must be taken by the patients to keep the infected limbs clean and hygienic, as they are prone to bacterial infection. Massage and exercises for infected limbs are also suggested which will help the patients to enhance the lymph flow and improve the condition of their limbs. These are best done under medical supervision.