Brugiosis is a parasitic disease caused by filamentous worms – filaria, the larvae of which spread hematogenously, and the sexually mature helminths affect the lymphatic system.

What are the causes?

The cause of the disease is Brugia malayi – a helminth nematode having an elongated filamentous shape with its body narrowing towards the ends. The length of the parasites is 22-100 mm, its width is 0.1-0.3 mm.

The development of filaria occurs with a change of hosts, the final of Brugia malayi being man and some species of monkeys. Intermediate hosts are the different species of mosquitoes from the following genera Culex, Aedes, Mansonia, Anopheles. Sexually mature filariae parasitize in the lymph nodes and vessels.

Female parasites give birth to larvae called microfilariae, which do not change morphologically and do not grow in the human body. Microfilariae have an average length of 0.127-0.32 mm, and a width of 0.005-0.1 mm.

They parasitize the circulatory system.
Brugia malayi is found in China, India, Indonesia, the Korean Peninsula, Japan, Malaysia and the Philippines.

There are 2 strains of Brugia malayi – periodic and subperiodic. The periodic variety is found more often, a person can become infected with it near the rice plantations, and with the subperiodic variety – in the forests.

Besides humans, Brugia malayi can also affect cats. In Indonesia, another causative agent of parasitosis is more common – Brugia timori.
The periodic strain of Brugia malayi is capable of invading humans only, while the subperiodic strain is also found in monkeys.

Both strains of Brugia malayi are characterized by nocturnal peaks of microfilariae shedding, but this is significantly less common in the periodic strain.

Sexually mature filariae are capable of parasitizing the human body for a very long time – up to 12 years, and according to some data, even up to 17 years, and microfilariae about 12 months.

What are the symptoms?

Allergic manifestations are usually observed about 3 months after the initial worming. Microfilariae are detected in the blood no earlier than 9 months. The disease begins with various allergic manifestations.

On the skin, especially on the hands, painful lesions of the type of exudative erythema appear, the lymph nodes in the groin areas, on the neck and in the armpits increase, painful lymphagitis, funiculitis, orchoepididymitis, synovitis, progressing to fibrous ankylosis, often occur. women usually develop mastitis.

In case of long-term and recurrent funiculitis and orchoepididymitis, a hydrocele occurs. An increase in body temperature to febrile levels is also characteristic, bronchial asthma and bronchopneumonia often develop.

2-7 years after the infestation, the disease passes into a second stage, which is mainly characterized by the involvement of the skin and deep lymphatic vessels with the development of varicose veins, disruption of the movement of the lymphatic fluid, compromising the integrity of the lymphatic vessels.

Painful lymphangitis with regional lymphadenitis occurs. At the same time, for several days, pronounced phenomena of general intoxication against the background of high body temperature are observed in cases of infestation.

The patient often vomits, and sometimes it is possible to fall into a state of delirium. The attack usually ends with profuse sweating. As a result of violation of the integrity of the lymph nodes, there is a leakage of lymph fluid and a decrease in the intensity of lymphadenitis.

Treatment of brugiosis

For this disease, to destroy sexually mature filaria, it is recommended to use albedanzole – an anthelmintic preparation with a broad spectrum of action in combination with ivermectin.

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