Dr. Shashank Kumar Srivastav (Intensive Care Specialist) needs a second opinion on this medical case.
FILARIAL🪱 NEMATODE * Infective L3 * Transmitted by mosquito 🦟- Culex, Anopheles * Adult in lymphatic tissue * Microfilaria in blood nocturnal 10pm-2am mostly * Adult female crucial pathogenesis (Dilatation of lymphatic vessel, lymphadenitis, obstruction to LNs) * Th1 down regulated, Th2 high, IL4 high * Transient local edema * Dermatolymphangitis * Chronic- Lymph varices, Hydrocele, elephantiasis, granuloma breast, chyluria. * Occult filariasis (Weingarten’s Syndrome): Hypersensitivity, not in blood, lungs, liver, spleen, eosinophilic granuloma, IgE diagnostic. * Classical Filariasis: inflammatory, microfilaria in blood and fluid, LNs, Lymphatic vessels, lymphangitis, lymphadenitis, NO Abs. * Tropical pulmonary eosinophilia: a/k/a Meyers-Kouwenaar syndrome. * DEC Provocative test- microfilaria in day time in blood. * Microfilaria NOT found in peripheral blood: Occult filariasis, Chronic filariasis(some cases), Wrong time. * Ag detection: Recent infection, more sensitive than microscopy, in day time also. * Abs: IHA, IFA, ELISA, RIA * Leishman/Giemsa staining * Membrane filtration concentration technique & knott’s technique * CXR: Dead & calcified worm in LN and pulmonary infiltrate in TPE. * USG Scrotum: Filarial dance sign. * DOC: DEC 6mg/Kg daily 12 days
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