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Mansonella perstans
Epidemiology:
1) Central Africa & northeastern South America
2) transmitted by biting midges (Culicoides)
Pathology:
1) adult worms reside in serous cavities (pericardial, pleural & peritoneal) & in mesentery & perirenal & retroperitoneal tissues
2) microfilariae circulate in the blood without periodicity
Clinical manifestations:
1) most individuals are asymptomatic
2) transient angioedema
3) pruritus
4) fever
5) headache
6) arthralgia
7) right upper quadrant pain
8) pericarditis & hepatitis may occur
Laboratory:
1) diagnosis is made by detection of microfilariae in peripheral blood or in serous effusions
2) eosinophilia
3) serology: anti-filarial antibodies
Management:
1) diethylcarbamazine (DEC) 8-10 mg/kg/day for 21 days
a) standard treatment
b) little evidence for effectiveness
2) cure assessed by disappearance of eosinophilia & symptoms
3) multiple course of treatment frequently necessary
4) mebendazole 100 mg PO BID for 30 days may be effective
General
Mansonella
Properties
KINGDOM: animal
PHYLUM: helminth
References
- Harrison's Principles of Internal Medicine, 14th ed.
Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 1216
- Harrison's Principles of Internal Medicine, 13th ed.
Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 920