infectious diseases
Mansonellosis
Mansonella streptocerca
M. streptocercais transmitted in tropical rainforests in west and central Africa and Uganda. The prevalence ofM. streptocercais not known. Nonhuman primates are occasionally infected, but are not major reservoirs of infection. The life cycle ofM. streptocercais similar to that ofM. perstansexcept that adult worms reside in the dermis of the upper trunk and shoulder areas. Microfilariae are found in the skin. Most people withM. streptocercaare asymptomatic. Thickening of the dermis, hypopigmented macules, and bilateral axillary or inguinal lymphadenopathy may be observed. UnlikeO. volvulus, adultM. streptocercado not form subcutaneous nodules. is made by identifying microfilariae in skin snips or biopsies. Eosinophilia is common. Serology may also be useful in identifying filarial infection, but it is not specific. Diethylcarbamazine (DEC) 2 mg/kg orally 3 times a day for 12 days is used to treatM. streptocerca. DEC kills both microfilariae and adult worms. However, it can exacerbate skin and systemic symptoms due to the release of antigens from dying microfilariae. DEC should not be administered to patients with concurrentO. volvulusor heavyLoa loainfections because of the potential for severe adverse effects. , patients should be assessed for coinfection with Loiasis , another filarial parasite, if they have been in areas of central Africa where both parasites are transmitted because 