Lymphatic Filariasis Disseminating to the Upper Extremity

Abstract

Lymphatic filariasis is the most common cause of acquired lymphedema worldwide (Szuba and Rockson, 1998). It is endemic to tropical and subtropical regions, and its effects are devastating. With over 100 million infected persons, it ranks second only to leprosy as the leading cause of permanent and long-term disability. Wuchereria bancrofti is the etiologic agent in 90% of cases. There is a dearth of published MRI findings with pathologically proven active infections, making this entity even more of a diagnostic dilemma. Imaging may provide the first clue that one is dealing with a parasite and may facilitate proper treatment and containment of this disease. This is the first report of pathologic correlation with MRI findings in the extremity in active filariasis. The magnetic resonance images demonstrate an enhancing, infiltrative, mass-like appearance with partial encasement of vasculature that has not been previously described in filariasis. Low signal strands in T2-hyperintense dilated lymphatic channels are seen and may depict live adult worms. We hypothesize that the low signal strands correspond to the collagen rich acellular cuticle. This, in combination with the surrounding hyperintense T2 signal, corresponding to a dilated lymphatic channel, may provide more specific MRI findings for active nematodal infection, which can prompt early biopsy, pathological correlation, and diagnosis.

An Overview of Filariasis

“…More than 882 million individuals across 44 countries globally are still at risk of lymphatic filariasis and need preventive treatment to halt the spread of this parasitic disease. In addition, filariae are frequent worms in both animals and humans since parasites belong to the invertebrate class (Maldjian et al, 2014). However, it is difficult to prove that a filarial infection is a zoonosis; this illness may spread spontaneously from animals to people.…”

Biting Pattern and Seasonality of Filariasis Vector of Mansonia spp. in Endemic Area of Banyuasin Regency, South Sumatera, Indonesia

“…The World Health Organization determines that South Asia region faces 55.7% of at the world risk population where 94.6% and 85.2% of the reported having lymphoedema and hydrocoele cases globally [2]. In general, filariasis is an infection of microfilariae by Wuchereria bancrofti, Brugia malayi, and Brugia timori which transmitted by mosquitoes [3], [4], [5]. Approximately 23 species of mosquito from five genera which are Mansonia, Anopheles, Culex, Aedes, and Armigeres are reported as the vectors of lymphatic filariasis [6], [7], [8], [9].…”

Antibody-Based Protective Immunity against Helminth Infections: Antibody Phage Display Derived Antibodies against BmR1 Antigen

“…The World Health Organization (WHO) has identified lymphatic filariasis as the second leading cause of permanent and long-term disability in the world, after leprosy. It is caused by microscopic, thread-like worms, namely Wuchereria bancrofti (W. bancrofti) , Brugia malayi (B. malayi) , and Brugia timori ( B. timori) [ 1 ] The complex life cycle of human filarial nematodes, especially W. bancrofti and B. malayi , involves mosquitos as transmission vectors [ 2 ]. The complex life cycle of the nematodes is mainly attributed to the complicated host immune response, a direct reflection of the host–parasite interaction.…”