Round filamentous parasite of filiform form, filaria( on photo), is widespread in all countries with tropical climate and causes serious complications in infection. Suffice it to say that of the 120 million people infected in the world according to WHO, forty million people became disabled. A disease caused by these parasites can affect people regardless of age and sex. Filariasis or elephantiasis is transmitted through insect bites from an infected person or animal.
The filaria body is covered from above with a dense shell, and its movement is provided by longitudinal muscles on the belly and back. The gastrointestinal tract of the parasite consists of a tube with a mouth opening at the beginning, which is located in a cavity filled with liquid. Nutrition for larvae and adults is proteins and fats, dissolved in lymph. Throughout life, which is between eight and 17 years old, the helminth and its larvae cause inflammation of the lymph nodes, ulcers on the body, eye damage and the heaviest lesion is elephantiasis, when the volume of the affected organ increases tens of times. Female parasites during this time can lead to a million larvae.
Symptoms of filariasis
With an external examination, the first symptoms of filariasis will be:
- itching at the spots on the skin;
- impaired pigmentation with spots on the skin( pictured);
- secreted under the skin nodes;
- swelling on the skin;
- eye diseases;
- inflamed lymph nodes enlarged in size;
- coughing attacks, distinct wheezing in the lungs.
To further clarify the diagnosis, further studies are carried out. On ultrasound, subcutaneous nodules are checked for parasites. On their presence testify:
- clear sealing edges;
- heterogeneous seal structure;
- noticeable movement inside the node.
In the second and third stages of the disease, a blood test is used to diagnose filariasis. In addition, the examination of damaged areas of the skin of the eye with an ophthalmoscope.
Genital filariasis
Parasites live in coils and with lymphatic duct obstruction, the urogenital system is affected. In men, the spermatic cord and testicles become inflamed. If the number of parasites is small, then they can coexist peacefully with the body for a very long time. Therefore, very often the symptoms of filariasis do not appear, and a person may not even know about the presence of a disease. However, with the increase in the number of parasites and the accumulation of products of their decay and vital activity, there is a significant thickening of tissues with an increase in their density.
The blockage of the lymphatic vessels of the spermatic cord with deep filarias leads to a significant increase in the genitals( scrotum) in men and boys. In the photo of filariasis, they simply amaze the ugliness of their forms. Physically, this disease does not kill, but creates very big problems in life because of the inability to find a job and arrange a personal life. In addition, parasites cause inflammation of the spermatic cord, which gives the accumulation of fluid in enormous sizes. As a result, a drop is formed on the scrotum, which is called hydrocele.
When the hydrocele passes to the chronic stage, the scrotum takes the form of a pear, urination becomes more difficult. Men have problems with sex life, the process of formation of spermatozoa is knocked off. The lack of treatment for dropsy can lead to serious complications. Invasion with larvae of the parasite at the same time as the testicle and appendages leads to the development of orchoepidymitis.
Lymphatic filariasis
The inflammatory process in the lymph nodes begins when larvae or adult specimens of helminths enter them. Their favorite places are knots in the groin and in the hips, which increase to seven centimeters in volume. Inflammation is provoked by clogging the vessels of this system with parasites that disrupt normal fluid flow. In addition, parasites mechanically affect the capillary walls, irritating it and contributing to its inflammation.
At the initial stage of the disease, palpation is painful, and edema appears around the vessels. In the future, painful dense strands are formed. After a complete blockage of the outflow of fluid, the walls of the vessel burst, and lymph flows out into the surrounding tissues. Depending on where the fluid has developed, various diseases develop. The pathology of the mammary glands in women causes mastitis, men have scrotal damage. The lymphatic filariasis includes brugia and vukherrioz, in which the lymphatic tract lesions of the genitourinary organs and legs are at the forefront. A clinical case of filariasis is fixed, when the mammary glands of women hang even below the knees, while in the male the weight of the scrotum is 102 kg.
When lymph enters the connective tissues of the joint, an inflammation of the synovial membrane develops with strong painful sensations and a restriction of the motor function of the joint. Penetration of it into the abdominal cavity causes a large accumulation of fluid, reaching 25 liters. Inflammation of the abdominal cavity, caused by lymphatic filariasis, is characterized by diarrhea with an admixture of lymph. Penetrating from damaged vessels into the bladder cavity, it provokes hiluria and hematochiluria with a change in the color of urine. Urine becomes a milky or pink shade, and by evening it can turn red. Filariasis in children can be congenital when an infected mother transmits the disease. This is especially true for boys, when a parasite enters the scrotum.
The filariasis of the heart provokes a Dirofilaria immitis worm parasitizing the left ventricle of the heart. Transmission is carried out using some types of mosquitoes. Sexual maturity does not reach the helminth, therefore microfilariae are not formed. However, cases of embolic infarction provoked by such an immature parasite have been noted. For the most part, dirofilariasis is recorded in the lungs and the main symptoms are chest pain, coughing, hemoptysis, fever with chills.
Treatment of filariasis
The choice of the treatment regimen for helminthic invasions caused by the parasitism of the extraintestinal nematodes of the Filariata order depends on their location. In any case, the treatment of filariasis includes:
- , the elimination of adult individuals disrupting lymph drainage;
- neutralization of the influence of larvae, affecting the allergization of the body;
- therapy of inflammation;
- removal of helminths and damaged tissues surgically.
To get rid of parasites and remove from the body of larvae, a one-time combination of antiparasitic drug preparations is taken. The specific choice of drugs is determined by the doctor. The most popular combination is Albendazole, Ivermectin and Diethylcarbamazine Citrate. Albendazole by its action destroys the cells of the digestive system of adult parasite and, paralyzing muscles, contributes to the death of helminths. The active substance of Ivermectin is aimed at paralysis and death of filaria due to the interruption of the transmission of impulses in the nervous system of the parasite.
Anthelminthic agent Diethylcarbamazine disrupts the work of mitochondria in the cells of the filariae when the ATP molecules are not produced, depriving the helminths of vital energy. To prevent allergic reactions as a result of the death of parasites some time after the main intake of drugs, take one of a series of antiallergic drugs. Zodak, Loratadin or Tsetrin, for three days, one tablet. With a very strong allergy, steroid hormones with anti-shock and anti-inflammatory effects are recommended.
For sexually mature worms, the most potent antiparasitic drug is Suramin. However, this drug is very toxic and due to nephrotoxic effects, it is necessary to constantly monitor the functionality of the kidneys. Surgery is necessary to remove the accumulation of filarias in the third stage of the disease. When the pile of parasites is located under the skin, the operation is performed under local anesthesia. The accumulation of helminths in the muscles requires spinal or general anesthesia. To avoid suppuration in the sutures after the operation, antibiotics are prescribed. For the treatment of dropsy testicles, one of two methods is used.
In the first case, after removing fluid from the cavity between the shells, a drug is injected that closes the lymph vessels. The second method involves an incision on the skin of the scrotum and removal of a portion of the inner leaf of the testicle shell, with overlapping inside and outside the seams. Restoration of lymph drainage by surgery is performed by removing the damaged portion of the vessel and connecting the remaining vessel to the nearest suitable vein.
Treatment of filariasis with folk remedies can be of some use only if the eyes are affected. In all other cases, only medicamental treatment is effective. The main thing in the prevention of the disease is also the use of drugs. For example, their active use in children aged three to four years, when infection mainly occurs, has allowed to reduce the number of cases of filariasis in humans in countries with a wide spread of it. Filariasis in Russia is rarely found with severe pathologies of the lymphatic system, skin, genitalia or vision. However, when manifestations of infection with filaria at an early stage are quite possible. Therefore, if a visit to countries where filariasis is very common, a person has symptoms of the disease, it is necessary to conduct a full study.