Bancroftian filariasis in Egypt: visualization of adult worms and subclinical lymphatic pathology by scrotal ultrasound.

Abstract

Abstract. The purpose of this study was to explore the value of scrotal ultrasound as a means of evaluating Bancroftian filariasis. Color Doppler ultrasound examinations were performed to look for subclinical hydroceles and motile adult filarial worms (dancing worms) in dilated lymphatics. Sixty-one male subjects from a filariasis-endemic area in Egypt were studied including 19 clinically normal microfilaria (MF) carriers (seven with dancing worms and eight with subclinical hydroceles), 13 MF-negative subjects with positive filarial antigen test results (three with dancing worms and seven with subclinical hydroceles), 22 exposed subjects with no MF and negative antigen test results (no dancing worms, four subclinical hydroceles), and seven subjects with clinical filariasis (no dancing worms, seven hydroceles). Thus, all men tested with clinical filariasis and most clinically normal subjects with either microfilaremia or filarial antigenemia had abnormal ultrasound examination results. Ultrasound findings often changed after therapy with diethylcarbamazine, with disappearance of dancing worms and development of new scrotal calcifications or hydroceles. This study confirms the value of scrotal ultrasound as a means of noninvasively visualizing adult filarial worms and assessing subclinical lymphatic damage in Bancroftian filariasis.

A longitudinal study of Bancroftian filariasis in the Nile Delta of Egypt: baseline data and one-year follow-up.

“…The second finding was that 21% of the subjects with isolated filarial antigenemia were microfilaremic one year later. This result, along with the observation that subjects with isolated parasite antigenemia often have subclinical pathology detectable by ultrasound, 23 supports the idea that antigen-positive endemic normal subjects should be treated for filariasis, both for their own benefit and to decrease the future prevalence of microfilaremia in their communities. However, the need for such therapy cannot be considered urgent; most subjects with isolated parasite antigenemia remained antigen-positive and amicrofilaremic one year later.…”

Filaria associated clinical manifestations in children in an endemic area and morbidity control by immunomonitoring and optimal DEC therapy: Sevagram experience

“…(22,23) had elegantly studied the characteristic movements of adult filarial worms known as filaria dance sign (FDS) by ultra sonographic study in scrotum and ditated lymphatics in subclinical hydroceles, tropical pulmonary eosinophilia (24) and more recently in scrotal and breast areas in children (25). Ultra sound findings often changed after therapy with DEC, with disappearance of dancing worms (26). These studies confirm the presence of filarial adult worms in clinical cases and thus active infection.…”

Penoscrotal Elephantiasis, Diagnosis and Therapeutic Care: Case Series and Literature Review

“…Plus, the lymphography also allows the evaluation of the possibility of surgical lymphovenous anastomoses; this technique has its limitations, and there is not always a concordance between lymphographic images and surgical exploration [12,13]. The ultrasound, the CT scan, and the MRI can even show a possible compressive origin (pelvic or abdominal tumor) [14]. The retrograde and voiding urethrocystography is requested as soon as a urethral inflammatory stenosis is suspected, when diagnosed, it must imperatively be treated at the same time as the cure of elephantiasis.…”