HELMINTHS – A REVIEW FOR MLS

(DIAGNOSTIC PARASITOLOGY)
SET 2
 Lymphatic Filariasis
CRITERIA W. bancrofti B. malayi
Microfilaria mean length 290 um 222 um
Cephalic length : breadth 1:1 2:1
Sheath in Giemsa smear Unstained, sheathed Pink, sheathed
Nuclei Regularly spaced; separate Irregularly spaced; overlapping
Tail nuclei Single row ; do not reach tail end Single row; reach tail end
Terminal nucleai Absent Present: 2 nuclei, bulge the
cuticle, spaced
Mf in blood smear Smoothly curved Kinky, not smoothly curved
Adult Male: 2-4 cm long Male: 1.3-2.3 cm long
Female: 8 – 10 cm long Female: 4.3-5.5 cm long
Mosquito vector Aedes, Culex, Anopheles Mansonia bonneae, M. uniformis
Periodicity Nocturnal Diurnal
Deformities Not severe Severe
Wuchereria bancrofti and Brugia malayi

-causes lymphedema, Diagnosis:

elephantiasis, Blood smear taken from
hydrocele 8 pm to 4 am. Stained
-microfilariae (Mf) are with Giemsa
in the bloodstream Absence of mf: dead
-tropical pulmonary worms, obstructed
eosinophilia (TPE) lymphatics, low infection
-chyluria of urine due -DNA probes
to increased chyle or Prevention & Control
lymph fluid “milky W. bancrofti is most widespread
-avoid mosquito bites than B. malayi
urine” -Pyrethrin soaked
Treatment: DEC, Endemicity: >50% in infected areas.
mosquito nets.
Ivermectin
 OTHER FILARIAL WORMS
CRITERIA Loa loa Manzonella Manzonella Onchocerca
perstans ozzaedi volvulus
Sheath in mf Present Absent Absent Absent
Adult Male: Length 3-4 cm 4.5-6.0 cm 3.2-6.2 cm 1.9-4.2 cm
Female 4-7 cm 7,9-8,9 cm 6.5-8.1 cm 33 – 50 cm
Microfilariae length 250-300 um 200 um Not indicated 315-360 um
Vector Chrysops fly Culicoides fly Culicoides fly Simulium fly
Geography Africa South America South America Africa, South Am
Lesions; Pathology “Calabar swelling,” Subcutaneous Lymphadenitis Subcutaneous;
of subcutaneous swelling, found in Parasites in body “leopard skin”;
tissue eye worm serous fluid cavities, serous tissue keratisis (blindness)
Treatment DEC, Suramin DEC DEC with little effect DEC
Diagnosis Blood smear Blood smear Blood smear; Blood smear
Knott’s Knott’s Knott’s Knott’s
concentration concentration concentration concentration
Nucleus at tail tip 2 rows at the tip No nucleus at tip No nucleus at tip No nucleus at tip