“CLINICO-PATHOLOGICAL STUDY OF SURGICAL LESIONS OF FILARIASIS”

Abstract

Background: Lymphatic lariasis, transmitted by mosquitoes is the commonest cause of lymphedema in endemic countries. Among 120 million infected people in 83 countries, up to 16 million have lymphedema. Microlariae ingested by mosquitoes grow into infective larvae. These larvae entering humans after infected mosquito bites grow in the lymphatics to adult worms that cause damage to lymphatics resulting in dilatation of lymph vessels. This earliest pathology is demonstrated in adults as well as in children, by ultrasonography, lymphoscintigraphy and histopathology studies. Once established, this damage was thought to be irreversible. This lymphatic damage predisposes to bacterial infection that causes recurrent acute attacks of dermato-lymphangio-adenitis in the affected limbs. Bacteria, mainly streptococci gain entry into the lymphatics through 'entry lesions' in skin, like interdigital fungal infections, injuries, eczema or similar causes that disrupt integrity of skin. Methods-This study was conducted among 124 patients who attended SOPD and Filaria clinic (103) and admitted in Surgical wards (21) of S.G.M Hospital Rewa. All incidence, surgical manifestations and clinical diagnosed of lariasis in surgical patients include the study. Children with <6 years of age, critically ill patients and cases where calcication has been established for the exclusion criteria. Follow up of the patients was done on 7th, 14th and 21th day and the treatment effects were recorded every time. Complications, progression / regression and over all effects were recorded. Results- Filarial disease was diagnosed in 124 patients. The majority of the patients with Filarial disease 28.22% and Microlaria positive 80% were in the age group of 21-30 years . Youngest patient was 7 years male with right thigh lymphedema and oldest patient was 74 years old male with bilateral hydrocele. male : female ratio with Filarial disease is 2.86:1. Regional lymphadenopathy was noted in 17.74%, overlying skin was inamed and oedematous in 12.9%, hypertrophic or thick skin 4.03%, ulceration and nodularity was present in 2.41% each .Maculopapular eruption and blisters was present in 1.61 % cases each. The commonest manifestation constituted 54.03% of cases. Epididymoorchitis was present in 25%, lymphangitis in 13.71%, lymphadenitis in 11.29%, hydrocele in 7.26%, and cellulitis in 4.84% cases. Funiculitis and elephantiasis in 4.84% and 4.03% respectively. Conclusion- Reducing the suffering caused by LF through morbidity management and disability prevention. The general population should be well educated and informed about the disease and prevention from mosquito bite. Patients who are already suffering from the disease should be made aware of the treatment modalities available and benets of promoting self-hygiene and self-help regimens. From the current study we can conclude that prevalence of laria in Vindhya Region is 0.11% which is less than 1% which was target under NPELF.