infectious diseases
Bancroftian and Brugian Lymphatic Filariasis
Key Points
Lymphatic filariasis is transmitted by mosquitoes; infective larvae migrate to the lymphatics, where they develop into adult worms. Adult worms inside the lymphatics can cause inflammation resulting in acute adenolymphangitis or epididymitis or in chronic lymphatic obstruction, which, in some patients, leads to elephantiasis or hydrocele. Diagnose based on microscopic detection of microfilariae in filtered or centrifuged concentrates of blood that is drawn at the time of day when microfilaremia peaks (varies by species). Tests for antigen, antibodies, and parasite DNA are alternatives to diagnosis by microscopy. Treat with diethylcarbamazine after excluding coinfection withLoa loaandOnchocerca volvulus. The Global Program to Eliminate Lymphatic Filariasishas reduced transmission in many endemic areas. 