eMedicine Specialties > Pediatrics: General Medicine > Parasitology
Dracunculiasis: Follow-up
Updated: Aug 22, 2006
Follow-up
Further Outpatient Care
- Close follow-up monitoring is necessary to track progression of extraction.
- Initially, warm compresses may be useful in relieving pain.
- Diligent cleaning of the wound site is necessary during and following extraction of the worm.
- Topical antibiotic ointments, such as bacitracin or mupirocin (Bactroban), can be applied to wounds to prevent secondary infection.
Deterrence/Prevention
- Prevention of the disease is through management of water supplies in endemic areas.
- Treatment of potentially contaminated water with the larvicide temephos (ABATE) is useful in controlling the spread of the infection. Additional preventative steps include filtering water through a finely woven cloth (to strain larvae), drinking water from only a borehole or hand-dug wells, and avoiding passive transmission by educating infected persons to avoid entering water sources.
- Areas with known outbreaks or more frequent infections must be identified, and equipment must be made available to clear drinking water in those areas.
- Unfortunately, civil unrest and governmental lapses have prevented clearance of many water supplies in several endemic nations. Numerous positive social and political steps are also important to create conditions for the interruption of disease transmission.
Complications
- See Mortality/Morbidity.
Prognosis
- With treatment, prognosis is very good. Without treatment, prognosis is still very good as long as serious secondary infection does not occur and remain untreated.
Patient Education
- Distribute information regarding the disease in endemic areas.
- Assist communities in maintaining clean drinking water supplies.
Miscellaneous
Medicolegal Pitfalls
- Incorrect diagnosis
- Initially missing the diagnosis of dracunculiasis is possible because of the infrequency of cases throughout the world, particularly in the western hemisphere.
- Major complications in this scenario include late diagnosis, resulting in an increased degree of individual patient morbidity and failure of timely epidemiologic notification of a case.
- In suspicious lesions, a travel history must be obtained and remembered to avoid this pitfall.
- Inappropriate treatment
- Although this scenario is much less likely than the one above, inappropriate treatment of dracunculiasis could be a potential issue, even if the diagnosis is made correctly.
- Consult an infectious disease specialist in any and all cases of suspected dracunculiasis outside of endemic nations to prevent inappropriate treatment or management.
- Reaction to treatment
- Care must be taken to ascertain whether the patient with dracunculiasis has ever taken any antiparasitic drugs and if they were ever noted to cause problems.
- A failure to do so with a resultant adverse reaction to prescribed medication is a clear-cut legal pitfall that should be eliminated in practice by following the standards of care and obtaining an appropriate patient history.
Special Concerns
- Patients with dracunculiasis are at risk for other parasitic infections because areas endemic for Dracunculus also are endemic for other parasites. During and after treatment for dracunculiasis, patients should be monitored for other symptomatology characteristic of parasitic infections.
More on Dracunculiasis |
| Overview: Dracunculiasis |
| Differential Diagnoses & Workup: Dracunculiasis |
| Treatment & Medication: Dracunculiasis |
 Follow-up: Dracunculiasis |
| References |
| « Previous Page |
References
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Further Reading
Keywords
dracunculiasis, dracontiasis, dracunculosis, guinea worm infection, Dracunculus medinensis, D medinensis, guinea fire worm, Medina worm, serpent worm, dragon worm
