Elephantiasis

What is Elephantiasis?

Elephantiasis is worms that dwell in the tissue beneath the skin and in the lymphatic system. Filariasis is a very common condition amongst people of India living in the coastal regions of Karnataka, Kerala, and Tamil Nadu.

There are many types of filaria worms. The commonest are Wuchereria bancrofti and Brugia Malayi. Humans are the only definite hosts for this parasite. The mosquito spreads this disease. Usually, infection is established only with repeated and prolonged exposure to infective larvae. After being infected by a mosquito, the larvae travel to the lymphatic system where they develop into adult worms. The offspring are termed microfilariae. They circulate in the blood or migrate to the tissue beneath the skin.

The principal changes result from inflammatory damage to the lymphatic system, which is caused by adult worms. These worms live within the lymphatic system and the lymph nodes. They cause lymphatic dilatations and thickening of the walls. These regions are infiltrated by cells of the body causing gross changes in the tissues leading to the tortuosity of the lymphatics and damage to the vessel valves. With obstruction to the flow of lymph, there is no stasis and hard brawny edema develops in the overlying skin. With the death of worms, further inflammatory changes take place leading to further complications in the lymphatic function.

Clinical Features of Elephantiasis

1. Initially the patient is asymptomatic and is clinically well.
2. Infected males develop swelling of the scrotum called Hydrocele or scrotal elephantiasis.
3. Fever may be present, chills, and local edema swelling. Episodes last 7-10 days.
4. Lymph nodes are enlarged. Lymphatic vessels are inflamed.
5. As lymphatic damage progresses to lymphatic obstruction, elephantiasis develops. There is a firm brawny swelling over one or both legs, which progress to become so thick and heavy that a patient has difficulty in walking.

Management:

Consult a physician.

Prevention of Elephantiasis

1.Use of mosquito nets.
2.Use of insect repellants.
3.Annual night blood tests.