Acantoheylonematosis (dipetalonematosis)

What is Acantoheylonematosis (dipetalonema)?

Acantoheylonematosis (acantocheilonematosis, dipetalonematosis) is a helminthiasis from the group of filariasis caused by Dipetalonema (Acanthocheilonema) perstans, which occurs with allergic phenomena and is characterized by pains in the abdomen and chest, dizziness, itching skin.

Acantoheylonematosis is found in countries in Africa and South America.

Causes of Acantoheylonematosis (dipetalonema)

Two causative agents of dipetalonema disease, Dipetalonema perstans and D. streptocerca, are described. Foci of filariasis caused by D. perstans, are mainly in the countries of West Africa, where the prevalence of the population reaches 50-90%, and some countries in Latin America (Venezuela, Brazil, Argentina). D. streptocerca is found in humid areas of Ghana, Nigeria, Cameroon, Zaire.

The male has a length of 40-45 mm, width 0.06-0.08 mm; female – 70-80 mm, width 0.12-0.14 mm.

Adults D. perstans live in the mesentery, pararenal and retroperitoneal tissue, in the pericardium, pleural cavity, and adults of D. streptocerca – in the skin. Here they mature.

The larvae (microfilariae) of D. perstans, born by adult helminths, are parasitic in peripheral blood and do not have a periodicity. Microfilariae D. streptocerca inhabit the skin.

The source of D. perstans invasion is a person, the final owner; The source of D. streptocerca infestation is monkeys, humans are extremely rare.

The pathogen carrier and intermediate host is biting midges of the genus Culicoides. Microfilariae trapped in the bloodsucking of an insect, acquire an invasive form in 7-10 days.

Pathogenesis during Acanthoylonematosis (dipetalonema)

The pathogenesis of acanthoylonematosis is not well understood. The microfilariae that are in the vascular bed cause stagnation of the lymph, dilation of the lymphatic vessels of the affected organs, liver microabscesses. Of great importance is hypersensitization to the products of vital activity of helminths.

Symptoms of Acanthoylonematosis (dipetalonema)

In clinical manifestations, skin and articular allergic syndromes play a leading role. Severe itching, erythematous or maculopapular rash, lymphadenitis, pain in the joints, in the region of the heart. Sometimes there are swelling of the face, limbs, scrotum. There are also bouts of fever, pain in the limbs, in the heart, abdomen, dizziness. Perhaps the development of meningoencephalitis. In these cases, microfilariae are detected in the cerebrospical fluid. In the blood, moderate or significant eosinophilia is detected. The described symptoms, however, are peculiar only to non-immune individuals. Local residents often have no clinical manifestations or only slightly. At the same time, it is precisely the indigenous people in the foci that have hydrocele and elephantiness due to this invasion.

Diagnosis of Acanthoylonematosis (dipetalonema)

The diagnosis is based on the detection of microfilariae in the blood.

Treatment for Acantoheylonematosis (dipetalonema)

Etiotropic therapy of acanthoylonematosis is performed with dithrazine, effective for not only microfilariae, but also other forms of helminth development. Mandatory appointment of desensitizing drugs, with pronounced allergic reactions – corticosteroids. With the development of elephantiasis, a bandage is shown.

The prognosis is favorable, subject to the exclusion of repeated infections and persistent treatment.

Prevention of Acanthoylonematosis (dipetalonema)

Prevention of acanthoylonematosis is carried out by destroying biting midges and protecting against their bites (special clothing, repellents).

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