Filariasis

Dr. Mejbah Uddin Ahmed

 Tissue nematode
Classification
A) According to habitat:
a) Lymphatic system: W. bancrofti, B. malyai, B.
timori
b) Subcutaneous tissue: D. medinensis, O.volvulus,
Loa loa
c) Mesentery: D. perstans, M. ozzardi
d) Conjunctiva: Loa loa.
 Tissue nematode
B) According to disease:

Disease Parasite
Lymphatic filariasis W.bancrofti,B. malyai,
B. timori
Loiasis/ calabar swelling Loa loa

Onchocerciasis / River O. volvulus

blindness

Dracunculiasis D. medinensis
 Filariasis

 Filariasis are a group of parasitic diseases

caused by nematodes reside in the lymphatic and
connective tissue (W. bancrofti, B. malyai, B.
Timori).
 Lymphatic filarisis

 Lymphatic filarisis is a debilitating and disfiguring

chronic disease (lyphoedema, elephantiasis and
hydrocele).
 Wuchereria bancrofti

 Morphological forms:
Adult worms
Microfilaria
 Adult worms:
The adult worms are white
Females are larger than males and
viviparous.
 Wuchereria bancrofti

 Microfilaria:
Average microfilaria measures 240–300 μm in
length. A thin delicate sheath surrounds the
organism. The head is blunt and round and the tail
is pointed. Except the tail tip numerous nuclei are
contained in the body.
 Wuchereria bancrofti

 Periodicity: The microfilarias are not constantly

found in the peripheral blood, but show nocturnal
periodicity. The exact mechanism is not fully
understood. It is determined by species and life
style of host and can be altered.
 Wuchereria bancrofti

 Life cycle:
 Definitive host: Man.
 Intermediate Host: Mosquito.
 Infective form: Microfilaria.
 Portal of entry: Skin, by mosquito bite.
 Site of localization: Lymphatic system.
Filariasis
 Wuchereria bancrofti

 Pathology & Clinical feature :

 May be asymptomatic
 Adult and developing worm causes classical
filariasis
 Microfilaria causes occult filariasis .
 Wuchereria bancrofti
 Classical filariasis:
 Acute lymphatic filariasis: In the acute form
there are recurrent attacks of fever with
lymphadenitis and lymphangitis. The lymphatics
involved are those of the limbs, genital organs
(specially spermatic cord) and breasts.
 Filariasis

 Causes of lymphangitis: Mechanical irritation,

liberation of metabolites, bacterial infection.
 Obstruction of lymphatics: Mechanical,
excessive fibrosis of lymph vessels and fibrosis of
afferent nodes.
 Filariasis
 Dilatation of lymphatics- Lymphangiovarix.
 Rupture of lymphnagiovarix
 Lymphorrhgia– Lymphscrotum, Lymphuria
Lymphocoele.
 Chylorrhagia–Chylocoele, chyluria, chylorrhgia or
hematochyluria, chylus diarrhoea, chylus ascitis
and chylothorax.
 Filariasis
 Elephantiasis: Affected part
becomes enlarged and
tumor like solidity due to
hypertrophy & hyperplasia of
skin and connective tissues
of various parts of the body.
 Secondary bacterial
infections: Septic
lymphangitis, abscess and
septicemia. Elephantiasis
 Filariasis
 Occult filariasis:
The condition when adult worm produces
microfilaria continuously but absent in the
peripheral blood because they are destroyed in
the tissues. This is characterized by massive
eosinophilia, hepatosplenomegali, generalized
lymphadenopathy & pulmonary symptoms.
 Filariasis

 Tropical pulmonary eosinophilia: A syndrome

of immunological hyper responsiveness of Mf in
the lung. It is particularly found in filaria endemic
areas. There is a marked eosinophilia, raised
ESR and high levels of filarial antibody including
high titers of IgE.
 Filariasis
Laboratory Diagnosis:
Sample: Peripheral blood, chylous urine, hydrocele
fluid and exudates of lymph varix.
Microscopy: Detection of microfilaria stained with
Leishman, Giemsa or hematoxylin and eosin stain.
Antigen detection: Using an immunoassay for
circulating filarial antigens constitutes a useful
diagnostic approach.
 Filariasis
 Molecular diagnosis: Polymerase chain reaction
is available for W. bancrofti and B. malayi.
 Identification of adult worms: is possible from
tissue samples collected from subcutaneous
biopsies.
 Antibody detection: Is of limited value.
 Complement fixation test.