Elephantiasis

Elephantiasis is chronic, often extreme enlargement and hardening of cutaneous and subcutaneous tissue, especially of the legs, hands and external genitals, resulting from lymphatic obstruction and usually caused by infestation of the lymph glands and vessels with a worm.




True elephantiasis is the result of a parasitic infection caused by three specific kinds of round worms. The long, threadlike worms block the body's lymphatic system—a network of channels, lymph nodes, and organs that helps maintain proper fluid levels in the body by draining lymph from tissues into the bloodstream. This blockage causes fluids to collect in the tissues, which can lead to great swelling, called "lymphedema." Limbs can swell so enormously that they resemble an elephant's foreleg in size, texture, and color.





Causes and symptoms:
Infected female mosquitoes take a blood meal from a human, and in doing so, introduce larval forms of the particular parasite they carry to the person. These larvae migrate toward a lymphatic channel, then travel to various places within the lymphatic system, usually positioning themselves in or near lymph nodes throughout the body. During this time, they mature into more developed larvae and eventually into adult worms. Depending upon the species of round worm, this development can take a few months or more than a year. The adult worms begin reproducing numerous live embryos, called microfilariae. The microfilariae travel to the bloodstream, where they can be ingested by a mosquito when it takes a blood meal from the infected person. If they are not ingested by a mosquito, the microfilariae die within about 12 months. If they are ingested by a mosquito, they continue to mature. They are totally dependent on their specific species of mosquito to develop further. The cycle continues when the mosquito takes another blood meal.
 
Stages of worm growth in the mosquito and the human body.

Diagnosis: 
the only sure way to detect elephantiasis is by detecting the parasite itself.

Treatment:

• The drug of choice in treating lymphatic filariasis is diethylcarbamazine (DEC)
• Surgery can be performed to reduce elephantiasis by removing excess fatty and fibrous tissue, draining the swelled area, and removing the dead worms