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Chapter 15 : Filarial Nematodes

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Abstract:

  • Basic Life Cycle
  • The Endosymbiont
  • Human Pathogens
    • Zoonotic infections (American brugian filariasis)
    • Tropical pulmonary eosinophilia
    • and spp.

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.1
Figure 15.1

Distribution of and infections in humans. (Armed Forces Institute of Pathology map.) doi:10.1128/9781555819002.ch15.f1

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.2
Figure 15.2

Life cycles of and . doi:10.1128/9781555819002.ch15.f2

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.3
Figure 15.3

. (Top) Microfilariae on membrane after concentration of venous blood with a Nuclepore filter. (Second) Microfilaria in a peripheral thick blood film. (Third) Head of (note the evidence of a sheath; all images stained using hematoxylin stain). (Bottom) Tail of (note the sheath; also, tail nuclei stop before the end of the tail [oval]). (From : a cooperative collection prepared and/or edited by H. Zaiman. Bottom three images courtesy of L. Garcia.) doi:10.1128/9781555819002.ch15.f3

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.4
Figure 15.4

Characteristics of human microfilariae. (A) ; (B) ; (C) ; (D) ; (E) ; (F) ; (G) . doi:10.1128/9781555819002.ch15.f4

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.5
Figure 15.5

Key to microfilariae commonly found in the blood. doi:10.1128/9781555819002.ch15.f5

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.6
Figure 15.6

female in lymph node (cross section). (Armed Forces Institute of Pathology photograph.) doi:10.1128/9781555819002.ch15.f6

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.7
Figure 15.7

(Left) Inguinal nodes enlarged due to filariasis. (Adapted from the Public Health Image Library, Centers for Disease Control and Prevention.) (Right) Scrotal lymphangitis due to filariasis. (Adapted from the Public Health Image Library, Centers for Disease Control and Prevention.) doi:10.1128/9781555819002.ch15.f7

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Algorithm 15.1
Algorithm 15.1

Bancroftian and Malayan filariasis. doi:10.1128/9781555819002.ch15.Alg15.1

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.8
Figure 15.8

elephantiasis of lower extremities. (Upper, from : a cooperative collection prepared and/or edited by H. Zaiman. Lower, adapted from the Public Health Image Library, Centers for Disease Control and Prevention.) doi:10.1128/9781555819002.ch15.f8

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.9
Figure 15.9

. (Top) Microfilaria demonstrating sheath (pink using Giemsa stain). (Middle, left) Head of microfilaria: note that the sheath is not that clearly visible; (right) head showing sheath stained with Giemsa stain (arrow). (Bottom, left) Tail of microfilaria: note the two terminal nuclei separated from the other nuclei (circle); the bulge around the first nucleus is not visible as in the next image; (right) tail of microfilaria: note the sheath and the two terminal tail nuclei, also note the slight bulge around the first tail nucleus (circle). Note the body nuclei are not as precise and separate as they are in . (Courtesy of the CDC Public Health Image Library). doi:10.1128/9781555819002.ch15.f9

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.10
Figure 15.10

elephantiasis of the lower extremity. (Courtesy of USAID's NTD Program, source Andrea Peterson.) doi:10.1128/9781555819002.ch15.f10

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.11
Figure 15.11

(Upper) Microfilaria. (Lower, left) Head: notice that the sheath does not stain with Giemsa—you are seeing the end of the head with the cephalic space before nuclei begin; (right) microfilarial tail. Note several terminal tail nuclei with no bulge in the tail (circle). (Courtesy of the CDC Public Health Image Library; image courtesy of Thomas C. Orihel.) doi:10.1128/9781555819002.ch15.f11

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.12
Figure 15.12

Life cycle of . doi:10.1128/9781555819002.ch15.f12

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.13
Figure 15.13

(Upper) microfilariae in blood. Note the presence of the sheath and the tail nuclei positioned to the end of the tail. (Lower, left) Head of : note the sheath stained with Giemsa stain; (right) tail of : note the sheath and the terminal nucleus at the tip of the tail (circle). doi:10.1128/9781555819002.ch15.f13

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.14
Figure 15.14

(Upper) . Subconjunctival nematode (box). (Lower) being removed from the eye. (From : a cooperative collection prepared and/or edited by H. Zaiman. Photograph courtesy of D. Gendelman.) doi:10.1128/9781555819002.ch15.f14

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Algorithm 15.2
Algorithm 15.2

Loiasis. doi:10.1128/9781555819002.ch15.Alg15.2

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.15
Figure 15.15

(Upper) Calabar swelling; note the one enlarged knee (see square). (Lower) Calabar swelling on hand (see square). (From : a cooperative collection prepared and/or edited by H. Zaiman.) doi:10.1128/9781555819002.ch15.f15

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.16
Figure 15.16

microfilaria. Note that the microfilaria is unsheathed and that the tail is pointed and slightly flexed and has a longer caudal space than seen in Fig. 15.17 (circle) (courtesy of the CDC Public Health Image Library). doi:10.1128/9781555819002.ch15.f16

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.17
Figure 15.17

microfilaria. Note that the microfilaria is unsheathed and there is very little tail space (circle) compared with the pointed tail of seen in Fig. 15.16 (courtesy of the CDC Public Health Image Library). doi:10.1128/9781555819002.ch15.f17

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.18
Figure 15.18

. Note the curved tail in both images (circles) (courtesy of the CDC Public Health Image Library). doi:10.1128/9781555819002.ch15.f18

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.19
Figure 15.19

Life cycle of . doi:10.1128/9781555819002.ch15.f19

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.20
Figure 15.20

microfilariae in the skin (oval) (cross section). (From : a cooperative collection prepared and/or edited by H. Zaiman.)doi:10.1128/9781555819002.ch15.f20

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.21
Figure 15.21

microfilariae; note the tail space (circle) (courtesy of the CDC Public Health Image Library).doi:10.1128/9781555819002.ch15.f21

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.22
Figure 15.22

Onchocerciasis. The nodules on both patients' heads contain adult worms of . (From : a cooperative collection prepared and/or edited by H. Zaiman.) doi:10.1128/9781555819002.ch15.f22

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.23
Figure 15.23

Onchocerciasis. Nodules on the back prior to surgical removal. (Courtesy of Medscape, Aileen M. Marty.) doi:10.1128/9781555819002.ch15.f23

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.24
Figure 15.24

Onchocerciasis. Note the exaggerated wrinkling of the skin as a result of atrophy and loss of skin elasticity. (Upper, courtesy of Clare Gilbert, International Centre for Eye Health, London School of Hygiene and Tropical Medicine [www.iceh.org.uk]. Lower, courtesy of United Front against Riverblindness [http://www.riverblindness.org/news-room/gallery-onchocerciasis].) doi:10.1128/9781555819002.ch15.f24

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.25
Figure 15.25

Onchocerciasis. (Top) Premature aging seen as a result of skin changes. (Middle and bottom) Hanging groin due to femoral lymphadenitis. (Courtesy of Brooke Army Medical Center teaching file; images in public domain.)doi:10.1128/9781555819002.ch15.f25

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.26
Figure 15.26

Onchocerciasis. Note the localized areas of spotty depigmentation surrounded by slightly hyperpigmented zones occurring mainly on the shins; this condition is known as leopard skin. (Courtesy of the Carter Center.) doi:10.1128/9781555819002.ch15.f26

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.27
Figure 15.27

Onchocerciasis. Man demonstrating the difference in color and appearance of his hands due to sowda. One hand is significantly darker and thicker. (Courtesy of WHO/TDR/Crump.) doi:10.1128/9781555819002.ch15.f27

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.28
Figure 15.28

Blindness caused by onchocerciasis. (Upper, courtesy of Christian Blind Mission UK; lower, courtesy of WHO/TDR.) doi:10.1128/9781555819002.ch15.f28

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.29
Figure 15.29

Onchocerciasis. (Upper) A physician takes a skin sample from a patient for a skin snip biopsy by elevating a piece of skin with a needle and shaving it off with a scalpel (there should be little to no blood). (Lower) A physician takes a skin sample from a patient for a skin snip biopsy using a sclerocorneal biopsy punch. (Images courtesy of Thomas B. Nutman, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health.) doi:10.1128/9781555819002.ch15.f29

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Algorithm 15.3
Algorithm 15.3

Onchocerciasis. doi:10.1128/9781555819002.ch15.Alg15.3

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.30
Figure 15.30

Onchocerciasis. (Upper) Injection of anesthetic prior to nodule removal. (Middle) Incision and nodule removal. (Lower) Nodule on the head prior to final removal. (From : a cooperative collection prepared and/or edited by H. Zaiman.) doi:10.1128/9781555819002.ch15.f30

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.31
Figure 15.31

. (Upper) Adult worm from dog's heart (courtesy of R. E. Pugh, www.parasite.org.au). (Lower) Adult worms in dog heart (courtesy of Simon F et al, 507–544, 2012). doi:10.1128/9781555819002.ch15.f31

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.32
Figure 15.32

Dirofilariasis. (Upper) Computed tomogram image with fine needle in left pulmonary round focus; round focus in right lung periphery (circle) (courtesy of Fueter R, Gebbers J-O, 2014, 1997). (Lower) Chest radiography in pulmonary dirofilariasis. A solitary smooth round nodule in right lower lobe without any clinical symptoms (courtesy of Marty AM, Andersen EM, p 920–927, Doerr W, Seifert G [ed], , 2nd ed, Springer, Berlin, Germany, 1995). doi:10.1128/9781555819002.ch15.f32

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.33
Figure 15.33

Human subcutaneous and ocular dirofilariasis. (Upper) (A) External appearance of a subcutaneous nodule in the ocular region. (B) Histological section of a nodule showing sections of adult worms. (C) Intravitreal location of an adult worm in a human patient. (Panels A and B courtesy of Vladimir Kartashev, University of Rostov Na Donu, Rostov, Russia. Panel C reprinted from Korkhov AP et al, 59, 2009, from Simon F et al, 507-544, 2012). (Lower, left) Localized conjunctival congestion with a yellowish cream, firm, nonmobile, nontender, scleral nodule (courtesy of Sangit VA, Haldipurkar SS, 76–77, 2012); (center) removal of adult worm from eye; (right) in eyelid. (Lower center and right, from : a cooperative collection prepared and/or edited by H. Zaiman.) doi:10.1128/9781555819002.ch15.f33

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Image of Figure 15.34
Figure 15.34

Dirofilariasis. (Top) sp. (suspect ) removed from the eye of a patient (courtesy of the CDC Public Health Image Library). (Middle) Cross section of adult worm consisting of thick multilayered cuticle (arrow), transverse striations (arrow), longitudinal wavy ridges (rectangle), and gravid uterus (X) (courtesy of Srinivasamurthy V et al, 349-351, 2012). (Bottom) A section from a subcutaneous mass due to showing the marked eosinophilic reaction; the arrow shows the regularly spaced longitudinal ridges and laminations of the cuticle of the worm (courtesy of Philip Palmer and Maurice Reeder, , Uniformed Services University of the Health Sciences [distributed by the American College of Radiology, the RSNA, the Radiology Outreach Foundation, and The International Society of Radiology with the kind permission of Springer Publishing, the authors, and the above institutions]). doi:10.1128/9781555819002.ch15.f34

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
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Tables

Generic image for table
TABLE 15.1

Characteristics of species causing human filariasis

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
Generic image for table
TABLE 15.2

Human filarial parasites and their vectors

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15
Generic image for table
TABLE 15.3

species infecting humans

Citation: Garcia L. 2016. Filarial Nematodes, p 377-417. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch15

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