Pediatric Filariasis Follow-up

  • Author: Robert W Tolan Jr, MD; Chief Editor: Russell W Steele, MD   more...
 
Updated: Jan 10, 2012
 

Further Inpatient Care

Observe for complications of filariasis therapy, especially if diethylcarbamazine (DEC) is used.

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Further Outpatient Care

Schedule a follow-up visit for 12 months after treatment; during this appointment, peripheral blood is examined for microfilariae.

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Inpatient & Outpatient Medications

Observe and monitor oral therapeutic plans with DEC because compliance with therapy is poor and usually incomplete.

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Deterrence/Prevention

Advise patients to avoid insect vector bites. Nationwide chemotherapeutic prevention programs are being implemented.[9, 10, 11]

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Complications

Secondary bacterial infection of elephantiasis may occur.

Peripheral nerve involvement in loiasis has been described.[12]

Epilepsy has been associated with onchocerciasis in some studies.[13]

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Prognosis

Prognosis is good if filariasis is recognized and treated early.

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Patient Education

Educate patients about protection against insect vectors and how to refrain from using self-treatment regimens, especially with DEC.

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Contributor Information and Disclosures
Author

Robert W Tolan Jr, MD  Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine

Robert W Tolan Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa, and Physicians for Social Responsibility

Disclosure: Novartis Honoraria Speaking and teaching

Specialty Editor Board

Rosemary Johann-Liang, MD  Medical Officer, Infectious Diseases and Pediatrics, Division of Special Pathogens and Immunological Drug Products, Center for Drug Evaluation and Research, Food and Drug Administration

Rosemary Johann-Liang, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Martin Weisse, MD  Program Director, Associate Professor, Department of Pediatrics, West Virginia University

Martin Weisse, MD is a member of the following medical societies: Ambulatory Pediatric Association, American Academy of Pediatrics, and Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Daniel Rauch, MD, FAAP  Director, Pediatric Hospitalist Program, Associate Professor, Department of Pediatrics, New York University School of Medicine

Daniel Rauch, MD, FAAP is a member of the following medical societies: Ambulatory Pediatric Association, American Academy of Pediatrics, and Society of Hospital Medicine

Disclosure: Baxter Honoraria Consulting

Chief Editor

Russell W Steele, MD  Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, and Southern Medical Association

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors Michael D Nissen, MBBS, FRACP, FRCPA, and John Charles Walker, MSc, PhD, to the original writing and development of this article.

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The life cycle of lymphatic filarioids in humans (Wuchereria bancrofti, Brugia malayi, Brugia timori) and the mosquito vectors (Aedes, Anopheles, Culex, and Mansonia genera) is shown. Life cycles for other filarioid nematodes (Onchocerca volvulus, Loa loa, Mansonella perstans) are identical. The body location of adult worms and the microfilariae differ, as do the arthropod intermediate hosts and vectors.
Lymphatic filariasis due to Wuchereria bancrofti causing limb lymphedema, inguinal lymphadenopathy, and hydrocele. Photograph taken by Professor Bruce McMillan and donated by Dr John Walker.
Adult worms of Wuchereria bancrofti in a cross section isolated from a testicular lump.
Microfilaria of Wuchereria bancrofti in a peripheral blood smear.
Shown here are onchocercomas of the forearm skin, also called sowda, in a Sudanese man.
Adult Onchocerca volvulus contained within onchocercomas of the skin.
Microfilariae of Loa loa detected in skin snips.
Microfilariae of Mansonella perstans in peripheral blood.
 
 
 
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