Bacteriologic Studies of Skin, Tissue Fluid, Lymph, and Lymph Nodes in Patients with Filarial Lymphedema

Wl, Olszewski; Jamal, Shahid; Manokaran, G; Pani, Sankarsan; Kumaraswami, V.; Kubicka, U; Lukomska, B; Dworczyński, A; Swoboda, E; Meisel-Mikołajczyk, F

doi:10.4269/ajtmh.1997.57.7

Cited by 108 publications

(64 citation statements)

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“…About 75 % of the studied sample with filarial ADL has positive levels of ASLO and/or ASDB antibodies, a result to be compared to the 50 % and 90 % percentages observed in a bancroftian (Vincent et al, 1998) and a brugian (Suma et al, 1997) lymphatic filariasis focus, respectively. These results, and previous bacteriological investiga tions (Olszewski et al, 1994;Shenoy et al, 1995), convincingly demonstrate that streptococci have a significant role, even if not exclusive, in the pathology of acute ADL associated to lymphatic filariasis. In addi tion, half of the patients with chronic pathology (but interestingly not with chyluria) have also antistrepto coccal antibodies.…”

Section: Discussionsupporting

confidence: 71%

“…The acute form of bancroftian filariasis involves lymphadenitis and lymphangitis, generally called adenolymphangitis (ADL) and is supposed to be, at least partly, a local immunological response to adult worms associated to mechanical damages of the lymphatic vessels made by these motile parasites. Repeated lymphatic damages related to adult worms activity is supposed to result in increased susceptibility to secondary bacterial infections, leading to progression of lymphoedema and elephantiasis (Olszewski et al, 1993(Olszewski et al, , 1994Schacher & Sahyoun, 1967;Shenoy et al, 1995 et al, 1998) associated morbi dity. The present study examined serologically infec tions with group AB hemolytic streptococci, one of the main common pathogenic bacteria in tropical areas with a marked affinity for the lymphatics, in ADL of filarial and bacterial (erysipela, see clinical definition in Chattier &Grosshans, 1990, andVincent et al, 1998) origins, compared to controls with the same eth nological and social conditions.…”

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confidence: 99%

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Role of streptococcal infection in the acute pathology of lymphatic filariasis

Esterre¹,

Plichart²,

Huin-Blondey³

et al. 2000

Parasite

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Summary:Growing evidence suggest that secondary bacterial, mainly streptococcal, infections contribute significantly to recurrent episodes of acute adenolymphangitis (ADL| of filarial origin. We examined the role of group A streptococci in the progression of lymphedema in Polynesian patients with filariasis-related ADL (22 cases) or chronic pathology (10 cases), or with erysipela (10 patients) and, as controls, in 20 healthy adults. Antistreptolysin O (ASLO) and anti-streptodornase B (ASDB) titers were systematically determined in parallel to parasitological and biochemical tests. ASLO and ASDB assays were positive in 100 % of erysipela, 75 % of filarial ADL as compared to 50 % of chronic pathology and 39 % of healthy controls. Interestingly, by opposition to ASLO titers which were not significantly different between the four groups, ASDB titers were higher in ADL (p = 0.019) and erysipela (p = 0.002) than in controls. These results support the hypothesis that recurrent streptococcal infections may have an important role in the pathogenesis of ADL in lymphatic filariasis.KEY WORDS : lymphatic filariasis, Wuchereri a bancrofti, group A streptococci, acute adenolymphangitis, French Polynesia. (Fan et al., 1995). The acute form of bancroftian filariasis involves lymphadenitis and lymphangitis, generally called adenolymphangitis (ADL) and is supposed to be, at least partly, a local immunological response to adult worms associated to mechanical damages of the lymphatic vessels made by these motile parasites. Repeated lymphatic damages related to adult worms activity is supposed to result in increased susceptibility to secondary bacterial infections, leading to progression of lymphoedema and elephantiasis (Olszewski et al., 1993(Olszewski et al., , 1994Schacher & Sahyoun, 1967;Shenoy et al, 1995 et al, 1998) associated morbi dity. The present study examined serologically infec tions with group AB hemolytic streptococci, one of the main common pathogenic bacteria in tropical areas with a marked affinity for the lymphatics, in ADL of filarial and bacterial (erysipela, see clinical definition in Chattier &Grosshans, 1990, andVincent et al, 1998) origins, compared to controls with the same eth nological and social conditions. MOTS CLES MATERIAL AND METHODS SERUM SAMPLESP rospective patients, examined by an experienced medical staff (Clinical Research Unit, Institut Malarde, Papeete, French Polynesia), were care fully questioned for a clinical history of recurrent epi sodes of ADL (Suma et al, 1997;Vincent et al, 1998). The selected population consisted of 22 patients with filarial ADL, 10 patients with chronic pathology (six hydroceles, two elephantiasis and two chyluria) and 10 with typical erysipelas and 20 endemic healthy controls of the same ethnological (Polynesian) and social (life-long residents of Tahiti island, Society archi pelago) conditions. After informed consent, diligent cli nical and laboratory investigations (complete hemogram, serum biochemistry and detection of microfilariae by Nucleopore® membrane fi...

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Section: Discussionsupporting

confidence: 71%

mentioning

confidence: 99%

Role of streptococcal infection in the acute pathology of lymphatic filariasis

Esterre¹,

Plichart²,

Huin-Blondey³

et al. 2000

Parasite

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“…Cellulitis is a common sequel that aggaravtes the morbidity. Bacterial entry into the subcutaneous tissue in those with skin changes is well documented [13].…”

Section: Resultsmentioning

confidence: 99%

Lymphoedema of the limbs: an experience from a tertiary clinic in the central province of Sri Lanka

et al. 2017

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ObjectiveA descriptive study to evaluate the pattern of presentation of lymphoedema of limbs to a tertiary care clinic in the central province of Sri Lanka. Patients and MethodPatients with lymphoedema seen over 28 years, (1980-2007) in the vascular clinic at the General Hospital Peradeniya were reviewed retrospectively. Results649 cases of lymphoedema of limbs were seen. 47 were in the upper limb, 36 of whom were secondary, mostly following axillary clearance associated with a mastectomy, and 11 cases were idiopathic. 602 patients had their lower limbs involved, with 96 cases amongst them being secondary, mostly to trauma, filariasis and a few with pelvic carcinoma and lymphoma. The rest (n =506) were considered to have lymphoedema of primary aetiology. The involvement of the legs was predominantly below the knees. A late onset group of lymphoedema patients, predominantly males above 60 years posed a problem in diagnosis and is worth future study.Complications among patients with lymphoedema of lower limbs with no overt secondary cause included inter digital cleft sepsis in 54.5 %, cellulitis or a history of the same in 66 %, lymphangitis 16 % lymphadenitis 3.5% and 11 % had septicaemia which aggravated the clinical state. ConclusionPrimary lymphoedema needs recognition as the dominant cause of limb lymphoedema especially in the Central Province. This diagnosis is required to prevent complications which need long term treatment. A filarial aetiology for most cases, as is popularly believed, is not evidence based. Secondary causes for lower limb lymphoedema must be looked for, such as pelvic malignancy and lymphoma. Trauma or surgery over lymphatic pathways should be avoided to prevent limb lympheodema. IntroductionNo significant documentation exists on the pattern of presentation of lymphoedema in Sri Lanka, though there exists records of its presence as a disease entity since the eighteenth century [1]. Lymphoedema is a disorder that has geographical implications such as possible association to Filaria [2], bare foot walking and the soil texture as in podoconioses [3]. It also involves genetic factors [4], with a pathogenesis seen to be of protean origin.The complications associated with lymphoedema, namely interdigital cleft sepsis, lymphangitis, lymphadenitis and cellulitis are quite disabling and aggravate the morbidity of the disease [5]. Surgical procedures that have been attempted to rectify lymphedema have yielded poor long-term results [5].The data regarding prophylactic care given to such limbs is inadequate, and makes it difficult to adopt focused and effective remedial measures. We present a database collected and collated over twenty eight years of attending to such patients in the hope that it will provide a scaffolding for care of this as yet mostly ignored area of clinical care. Patients and MethodOver a period of 28 years , 649 patients with limb lymphoedema were seen in the vascular clinic of the General Hospital Peradeniya. Majority of patients were from Central Province of Sri Lan...

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“…Adicionalmente, como recomendação individual, pode-se utilizar medidas compressivas. Durante os episódios bacterianos agudos (denominados de dermatolinfangioadenite aguda ou DLAA) 52 , são de fundamental importância o uso de compressas frias no local afetado até o desaparecimento da dor, o repouso, a elevação do membro afetado e a antibioticoterapia sistêmica (oral ou parenteral, dependendo da severidade do quadro clínico), principalmente nas primeiras 48 horas após o início do quadro agudo. Os antiinflamatórios não devem fazer parte do tratamento pela sua ineficiência nesses casos.…”

Section: Tratamento Quimioterápico Antifilarialunclassified

Recomendações para o tratamento da filariose bancroftiana, na infecção e na doença

Dreyer

Norões

2002

Rev. Soc. Bras. Med. Trop.

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Resumo As bases para se instituir o tratamento da filariose linfática são: prevenir, reverter ou diminuir a progressão da doença e interromper a transmissão do parasita. A escolha das medidas mais adequadas para o tratamento dos pacientes portadores de filariose linfática requer o conhecimento das diversas manifestações clínicas, assim como os seus diferentes mecanismos patogênicos. No passado, o tratamento da filariose era baseado somente na prescrição da droga antifilarial, porém, para os pacientes apresentando as manifestações agudas ou crônicas da doença, é imperativo que outras medidas sejam indicadas, incluindo higiene e dieta. Assim, essa nova visão multidisciplinar terapêutica é tão ou mais importante do que o início imediato da terapia antifilarial. Independentemente da manifestação clínica do paciente, três componentes estão agora indicados: 1) os cuidados clínicos e higiênico-dietéticos específicos para as diversas manifestações clínicas, 2) a educação e o suporte psicológico e finalmente 3) o tratamento quimioterápico com a dietilcarbamazina (DEC) ou a combinação de DEC e ivermectina. Os autores descrevem também as eficácias relativas macro e microfilaricidas da dietilcarbamazina e da ivermectina sozinhas ou em combinação usadas em programas de tratamento em massa para interrupção da transmissão e comentam sobre a introdução do uso da higiene em programas de saúde pública para a prevenção do linfedema. Palavras-chaves: Controle. Tratamento. Dietilcarbamazina. Ivermectina. Bancroftose. Elefantíase.Abstract The goals of treatment for lymphatic filariasis are: to prevent, reverse, or halt progression of disease; and to interrupt transmission of the parasite. Selecting the appropriate therapy for the patient with lymphatic filariasis requires knowledge of the various clinical features of filarial disease and their pathogenesis. In the past, treatment of lymphatic filariasis has focused primarily on antiparasitic chemotherapy; however, for many of the acute and chronic manifestations of lymphatic filariasis, it is now clear that supportive or other forms of clinical care are even more important than antiparasitic medication in order to prevent worsening of the disease. Regardless of the clinical manifestations of filarial disease in a particular patient, the following three components of treatment should, in general, be considered: supportive or disease-specific clinical care (including higiene and diet), patient education and counseling and finally, antiparasitic chemotherapy with diethylcarbamazine (DEC) and/or the combination of DEC with ivermectin. The authors also describe the proportional efficacy of diethylcarbamazine and ivermectin, alone or in combination, for use in mass treatment aiming at transmission interruption and the use of hygiene as a public health approach for lymphedema prevention. Key-words: Control. Treatment. Diethylcarbamazine. Ivermectin. Bancroftian filariasis. Elephantiasis. Nos últimos anos, a filariose linfática tem surgido como um problema crescente em saúde pública em vária...

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Bacteriologic Studies of Skin, Tissue Fluid, Lymph, and Lymph Nodes in Patients with Filarial Lymphedema

Cited by 108 publications

References 0 publications

Role of streptococcal infection in the acute pathology of lymphatic filariasis

Role of streptococcal infection in the acute pathology of lymphatic filariasis

Lymphoedema of the limbs: an experience from a tertiary clinic in the central province of Sri Lanka

Recomendações para o tratamento da filariose bancroftiana, na infecção e na doença

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