Questions and Answers
The ELISA test is used to detect IgG antibodies against Toxocara, making it a helpful diagnostic method for Lymphatic Filariasis.
True
Diethylcarbamazine is the primary treatment for most patients with Lymphatic Filariasis due to its lack of side effects.
False
Elephantiasis can occur as a complication of Lymphatic Filariasis but is not associated with neurological issues.
False
Dracunculus medinensis is classified as a true filarial disease, leading to its similar symptoms and complications.
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The majority of people affected by Guinea worm disease (GWD) have reliable access to safe drinking water and health care.
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Ivermectin is administered in a multiple-dose regimen akin to Diethylcarbamazime.
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Brugiya timori was first documented in the year 1964.
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Albendazole is the primary treatment for lymphatic filariasis.
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The side effects of DEC can be attributed to the sudden death of a large number of microfilariae.
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Mechanical devices have no role in the reduction of edema associated with elephantiasis.
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Both DEC and Ivermectin share a similar percentage of recurrence after treatment.
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Doxycycline is used to target Wolbachia in the treatment of lymphatic filariasis.
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Spraying houses with insecticides effectively controls all mosquito species.
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Toxocara spp primarily spread through lymphatic filariasis mechanisms.
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Visceral larval migrans can be diagnosed through imaging techniques that reveal eosinophilic granulomas.
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Elephantiasis is a common consequence of Toxocara infection.
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Toxocara spp and lymphatic filariasis differ significantly in their pathogenicity and the systems they primarily affect.
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Treatment options for Toxocara infections typically include anti-parasitic medications.
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Eosinophilia is a common symptom present in all types of Toxocara infections.
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Neurological complications such as seizures can occur in cases of neural toxocariasis.
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Ocular larval migrans can only be diagnosed with invasive procedures.
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Study Notes
Diagnosis
- Definitive diagnosis requires a biopsy, which is time-consuming and challenging.
- Clinical and serologic tests include:
- ELISA test utilizing Toxocara excretory-secretory antigens to detect IgG antibodies.
- Western Blot test for specificity, but cannot distinguish between new and old infections.
- Identification focuses on typical clinical signs of Ocular Larva Migrans (OLM) and Visceral Larva Migrans (VLM).
- History of exposure to cats and dogs is significant for diagnosis.
- MRI imaging can be useful.
- PCR testing may provide additional diagnostic information.
Treatment
- Common anthelminthic treatments include albendazole or mebendazole, often combined with anti-inflammatory steroids.
- Diethylcarbamazine (DEC) is effective but infrequently used due to severe side effects.
- Many patients can recover without treatment, but mandatory anthelminthic treatment is needed for neurological, lung, or cardiac complications.
Dracunculiasis
- Also known as Guinea worm disease, associated with seasonal transmission and can have animal hosts (e.g., dogs).
- It is prevalent among the poorest populations lacking access to safe drinking water and healthcare, linking it to poverty.
Filarial Treatment
- Diethylcarbamazine is the standard treatment for most filariasis, at a dosage of 2 mg per kg three times daily for 12 days.
- It clears microfilariae from the blood but can cause significant side effects, likely due to a sudden die-off of microfilariae.
- Ivermectin is almost equally effective, administered as a single dose, with a recurrence rate of 10% to 20% after 3 to 6 months.
Other Treatments
- Albendazole and doxycycline targeting Wolbachia may be used.
- For acute dermatological lymphatic filariasis (ADLA), management includes bed rest, analgesics, topical and systemic antibiotics, and elevating affected limbs.
Prevention
- Effective prevention strategies include mosquito control and reducing human sources of infection.
- Spraying insecticides and using bed nets can protect against mosquito bites, although economic issues may limit effectiveness.
Brugia timori
- First documented in Timor in 1964; longer microfilariae than B. malayi with a 2:1 cephalic length-width ratio.
- Toxocara spp., particularly T. canis and T. cati, predominantly affect children, transmitted via soil.
Toxocara spp.
- Most infections are asymptomatic as humans are accidental hosts for Toxocara species.
- Ocular and visceral larva migrans are key manifestations, with covert toxocariasis (coTOX) presenting less specific symptoms.
Pathology of Visceral Toxocariasis
- Migration and death of larvae cause eosinophilic granulomas, affecting the liver, lungs, CNS, and eyes.
- Common symptoms include wheezing and respiratory issues; may lead to liver enlargement and myocarditis.
Pathology of Ocular Larva Migrans
- May result in diffuse unilateral subacute neuroretinitis (DUSN), the invasion of the retina being the most severe outcome.
- Requires differentiation from retinoblastoma.
Covert Toxocariasis (CoTox)
- Often asymptomatic; may exhibit non-specific symptoms like eosinophilia, chronic abdominal pain, and sleep disturbances.
Neural Toxocariasis
- Uncommon cause of eosinophilic meningoencephalitis, often food-borne, potentially leading to seizures and coma.
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Description
This quiz explores the diagnostic methods and treatment options for Toxocariasis, including serologic tests like ELISA and Western Blot, as well as imaging techniques and case history. Additionally, it covers the use of medications such as albendazole and mebendazole in the management of the disease.
