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Brugiosis: Causes, Symptoms, Diagnosis, Treatment
Last reviewed: 23.04.2024
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Brugiosis is a transmissible helminthiasis. Adult individuals live in lymphatic vessels, and larvae (microfilariae) live in the blood.
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The cycle of development of brugioz
The cycle of development of brugia almost does not differ from vukhereerii. The ultimate host is a man, but there may be monkeys, cats. Brugoosa carriers are mosquitoes of the genus Anopheles, Mansonia and Aedes.
Epidemiology of brugioz
Brugia is endemic only in the countries of South-East Asia, where its area coincides with the area of wuchererosis: some areas of India and China, South Korea, Vietnam, the Philippines, Malaysia, Thailand, Indonesia.
The periodic strain of Malay brugiosis is distributed on the territory of the Indochina Peninsula, in Central India, South China, Japan and Indonesia, where Brugia is anthropogenous disease : the final host is a man, and the carriers are the mosquitoes of the genera Anopheles, Aedes, Mansonia.
A subperiodic strain of brugia with a nighttime peak of activity is found in the territory of the Malaysian swampy forests both in humans and in monkeys (macaques, loris), wild and domestic cats. Here it is a zoonotic natural focal infestation, the mosquitoes of the genus Mansonia are carriers .
The Timorese Brugius is very limited, in the Indonesian archipelago and on the island of Timor. Here it is anthroponosis with a night periodicity of the appearance of microfilariae in the peripheral blood. Carriers are mosquitoes of the genus Anopheles.
The source of the invasion is infected people or monkeys and cats. Infection occurs when the final host bites a mosquito.
What causes Brugia?
Brugia is caused by Brugia malayi and Brugia timori. The causative agent Malayan brugioza known two strains: periodic and subperiodic. Female are 55 mm long, 0.15 mm wide, males 23-25 mm and 0.088 mm, respectively. Brugia is smaller than the wucherei, their head end separated by a neck from the rest of the body. Microfilariae with a sheath have a length of 0.12-0.26 mm and a diameter of 0.05 mm.
Symptoms of brugioz
The pathogenesis and symptoms of brugioz are very similar to those of vecheriosis. In brugioze, ulceration of the affected lymph nodes often occurs. Practically there are no lesions of genitals and hiluria. Localization of elephantiasis is noted on the lower legs and forearms.
With Timorese brugiosis, abscesses of lymph nodes develop more often, the appearance of elephantiasis occurs on the legs, as in Malay brugioze.
Diagnosis of brugioz
Differential diagnosis of brugiosis should take into account the structure of the posterior end of the body of microfilariae. Larvae under the cuticle show a layer of well-colored nuclei. The location of these nuclei is not the same for different types of filaria. This allows you to differentiate brugiy from other types of filaria.
Laboratory diagnostics of brugioz
The diagnosis is made, as in the case of Vucereriosis, when larvae are found in the peripheral blood at night, but they can be detected in the daytime.
What tests are needed?
Treatment of brugioz
Treatment of brugioz is the same as with vucererioze, but allergic reactions to diethylcarbamazine (DEC) are stronger, which requires lower doses and the use of antihistamines. The reaction to ivermectin is weaker, it is effective in a small dose (20 μg / kg).
With Timorese brugioze, the treatment of DEC is effective, there are no advantages with ivermectin before DEC.
How to prevent brugia?
Prophylaxis of brugioz is the same as with vucereriasis.