Elephantiasis

Elephantiasis, also termed as Lymphatic filariasis, is a tropical disease that causes abnormal enlargement of body parts associated with pain and severe disability of the affected area. Elephantiasis is caused by parasitic worms that include Wuchereria Bancrofti, Brugia malayi and B. timori which are transmitted to humans via female mosquitoes. The infected mosquito injects the worm larvae into the person's blood stream. The worm spreads to the lymphatic system and blocks lymphatic drainage, leading to fluid build-up in the affected body part. Accumulation of fluids results in extreme swelling of that area. The disease normally affects the lower extremities, but it may also affect the male and female genital organs, breasts and groin area. Elephantiasis is most commonly found in African nations.

Symptoms of Elephantiasis

Inflammation and swelling is the most obvious symptom of elephantiasis. Ulceration and thickening of the skin around the affected region is another common symptom of this medical condition. Other than these symptoms, Elephantiasis may also produce following symptoms:

1. Fever
2. Headache
3. Pain in or above testicles
4. Enlarged groin lymph nodes
5. White urinary discharge
6. Swollen liver
7. Swollen spleen

Diagnosis of Elephantiasis

Elephantiasis is easily identified by a physical exam but, definitive diagnosis is done by examining the presence of microfilariae in a blood (blood is always collected at night) smear by microscopic examination.

Treatment of Elephantiasis

Diethylcarbamazine or DEC is a common drug that is administered to erase the microfilariae from blood. DEC works on the larvae but is not very effective on adult worms. Hence series of courses of DEC treatment stretching over a long time period may be required to rid the patient of the parasites. Along with DEC, another drug called Ivermectin is also used in some hospitals to treat elephantiasis. Though a rare option, surgery may also be performed to remove the fatty and fibrous tissue. However surgery is resorted as a last option as it is highly complicated and results are not very encouraging.

Other than addressing the infection, symptomatic treatment is undertaken to relieve the patient of discomfort. Pressure bandages are wrapped around the swollen limb and elastic stockings are also advised to reduce the pressure. Patient is also educated on few exercises and elevation techniques to combat swelling. Massage of the affected area is also recommended to facilitate smooth lymph flow.

Prevention of Elephantiasis

Elephantiasis is best managed by adopting few preventive measures. DEC can be administered preventively, to the whole of the community or region that is prone to elephantiasis. This kind of mass treatment reduces the number of carrier insects in a particular area. Effective mosquito control and clearing the areas of stagnant water is also important step towards the prevention of elephantiasis.

Lymphogranuloma Venereum

Lymphogranuloma Venereum or LGV is caused by the Chlamydia trachomatis bacteria. This is caused most often by sexual contact but it can also occur due to other reasons. Lymphogranuloma Venereum is a sexually transmitted disease (STD) that is more prevalent in the tropical areas. Lymphogranuloma Venereum affects the lymph nodes and causes scarring and destruction of tissue. In the initial stage, Lymphogranuloma Venereum remains as a painless blister. When the disease lasts for a few months, it can spread to the lymph nodes. This may lead to lymphatic obstruction, chronic edema and fibrosis. Left untreated, it can lead to Genital elephantiasis.

Lymphogranuloma Venereum manifests as a small painless ulcer on the male or female genitalia. Swelling and tenderness is experienced in the surrounding lymph nodes. A patient suffering from Lymphogranuloma Venereum may have fever and loss of appetite. There may be drainage from the inguinal lymph nodes and redness and swelling. Women might notice abdominal pain and fistulas.

Multiple sexual partners is a leading cause for Lymphogranuloma Venereum. A blood test can confirm lymphogranuloma venereum based on antibodies against Chlamydia trachomatis. Biopsy of the lymph node or serology test for LGV are also conducted to help diagnose the condition. Antibiotic therapy can cure Lymphogranuloma venereum. Medications such as Tetracycline, Doxycycline, Erythromycin are prescribed.