Wuchereriosa

Human lymphatic filariasis is mainly caused by Wuchereria bancrofti, Brugia

malayi, and Brugia timori. Bancroftian filariasis,
W. bancrofti, is responsible for 90% of lymphatic filariasis and widely distributed
throughout the tropics and subtropics.
B. malayi infection is endemic in Asia such as China, Korea, India, Indonesia,
Malaysia, Philippines, and Sri Lanka.
B. timori infection occurs in Indonesia (islands of Alor, Flores, and Timor).
 Wuchereria bancrofti on blood smear

A blood smear stained with Giemsa stain reveals infection with microfilariae
of W. bancrofti.
Unless picked up
by a mosquito female at feeding, the microfilariae will die in infected
humans.
Microfilariae of W. bancrofti are in a protective sheath until they penetrate
into the mosquito’s thoracic muscles.
Microfilaria of Wuchereria bancrofti collected by filtration
with a nucleopore membrane. Giemsa stain, which does not
demonstrate the sheath of this sheathed species (hematoxylin
stain will stain the sheath lightly). The pores of the membrane
are visible.
Bancroftian filariasis.
Blood smear showing sheathed microfilaria of Wuchereria bancrofti
Found in Central Africa
and parts of Asia,
Wuchereria Bancrofti is
carried by mosquitoes and
caused a condition known as
elephantiasis. This parasite
makes its way to the lymph
nodes and brings about
grotesque swelling.
(© Sheldan Collins/Corbis.
Reproduced by permission.)
Elephantoid legs in early stages
A random
group of men
infected with
human
W. bancrofti in
southern
coastal area
of Tanzania.
There,
the primary
vector
is Culex pipiens
breeding in pit
latrines.
Elephantiasis
Elephantiasis of the left
leg of a patient from
India, caused by W.
bancrofti. The vector in
urban filariasis in India
is Culex pipiens breeding
in highly polluted water.
Disfigurement of
elephantoid limbs is
irreversible. Filariasis is a
chronic disease that poses
a tremendous economic
burden in affected
countries.
Lymphadenopathy in filariasis. Lymphedema involving both lower
extremities is present in a young man from the Dominican Republic.
Lymphatic filariasis currently affects 120 million
people worldwide, and 40 million of these people have
serious disease.
Bancroftian Filariasis.
Pronounced oedema of the right leg in a woman in Porto Limon,
Costa Rica.
Elephantiasis of both legs due to filariasis. Luzon, Philippines.
This image shows 3 patients with advanced stage of
infection with Wuchereria bancrofti parasite also called
Bancroftian filariasis. Another name for this illness is
Elephantiasis
Genital enlargement of filariasis.
A and B. Moderate and marked genital enlargement due to
infection with W. bancrofti is shown.
Filariasis presenting with chyluria.
Left: Lymphangiogram showing contrast within the lymphatics
passing in a retrograde manner within the kidneys.
Right: Concurent IVP, showing contrast within the renal pelvis
and ureters.
Filariasis.
The milky urine (right) clears
with the addition of chloroform
(left). Milky-looking lymph
draining from the lower limbs
(chyle) passed into the urine as a
result of a reverse flow in the
kidney, from cortex to pelvis.
This reversal is occasioned by
proximal lymphatic obstruction
higher in the abdomen or thorax.
Microfilaria of Brugia malayi, collected by the Knott
(centrifugation) concentration technique, in 2% formalin wet
preparation. Note the erythrocyte ghosts (for size comparison)
and the clearly visible sheath that extends beyond the anterior
and posterior ends of the microfilaria. (There are 4 sheathed
species: Wuchereria bancrofti, malayi, timori, and Loa loa.)
Microfilaria of Brugia malayi
(thick blood smear;
hematoxylin stain). Like
Wuchereria bancrofti, this
species has a sheath (slightly
stained in hematoxylin). In
contrast with Wuchereria
bancrofti, the microfilariae in
this species are more tightly
coiled and the nuclear column
is more tightly packed,
preventing the visualization of
individual cells.
Filariasis. Microfilaria of Brugia malayi.
Detail from the microfilaria of Brugia malayi (see image above)
showing the tapered tail, with a subterminal and a terminal
nuclei (seen as swellings at the level of the arrows), separated
by a gap without nuclei. This is characteristic of B. malayi.
This photomicrograph shows the inner body and cephalic space of
a Brugia malayi microfilaria in a thick blood smear. B. malayi, a
nematode that can inhabit the lymphatics and subcutaneous
tissues in humans, is one of the causative agents for lymphatic
filariasis. The vectors for this parasite are mosquito species from
the genera Mansonia and Aedes.
Loasis. A microfilaria of L. loa in the peripheral blood. The
microfilaria measures about 300 µm long.
Microfilariae of Loa loa (right) and Mansonella perstans
(left). Patient seen in Cameroon. Thick blood smear stained
with hematoxylin. Loa loa is sheathed, with a relatively dense
nuclear column; its tail tapers and is frequently coiled, and
nuclei extend to the end of the tail. Mansonella perstans is
smaller, has no sheath, and has a blunt tail with nuclei
extending to the end of the tail.
Loaisis Top: Subcutaneous
worm involving the patients
ezelid.
Bottom: A few seconds later,
the worm has disappeared.
Loasis.
Threadlike adult L.loa migrating in the subconjuctival tissues.
Microfilaria of Mansonella streptocerca from a skin
snip. Fixed in 2% formalin and stained with hematoxylin. The
microfilaria is unsheathed, has a nearly straight body attitude,
the tail is typically coiled into a “shepherd’s crook”, and
terminal nuclei extend as a single row to the end of the tail.
Mansonella ozzardi, infectious agent of filariasis.
Tropical pulmonary
eosinophilia. A 48-year-old
indian male presented with 3
months of cough, sputum,
wheeze and dyspnoea:
widespread crepitations were
audible at presentation. 10,3
x 10 eosinophils were
present, and the filarial
complement fixation test was
positive. His symptoms and
eosinophilia resolved after
treatment with
diethylcarbamazine.
The chest x-ray showing
diffuse mottling and
increased bronchial
marking.