Loa loa - Revision history

Aidan at 17:06, 27 September 2024

2024-09-27T17:06:24Z

← Older revision		Revision as of 17:06, 27 September 2024
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	**[[Albendazole]] as above to decrease levels below 8000, followed by DEC as above		**[[Albendazole]] as above to decrease levels below 8000, followed by DEC as above
	**Apheresis to decrease levels below 8000, followed by DEC as above		**Apheresis to decrease levels below 8000, followed by DEC as above
			*[[Levamisole]] 0.25 mg/kg p.o. once is a promising new treatment[[CiteRef::campillo2021sa]]
	*[[Levamisole]] 0.25 mg/kg p.o. once is a promising new treatment<ref>Jérémy T Campillo, Paul Bikita, Marlhand Hemilembolo, Frédéric Louya, François Missamou, Sébastien D S Pion, Michel Boussinesq, CédricB Chesnais, Safety and Efficacy of Levamisole in Loiasis: A Randomized, Placebo-controlled, Double-blind Clinical Trial, ''Clinical Infectious Diseases'', Volume 75, Issue 1, 1 July 2022, Pages 19–27, https://doi.org/10.1093/cid/ciab906</ref>
	*Can consider concomitant [[antihistamines]] or [[corticosteroids]] during the first week of treatment to decrease symptoms associated with treatment		*Can consider concomitant [[antihistamines]] or [[corticosteroids]] during the first week of treatment to decrease symptoms associated with treatment

Aidan: added line about levamisole

2022-08-30T12:19:55Z

added line about levamisole

← Older revision		Revision as of 12:19, 30 August 2022
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	**[[Albendazole]] as above to decrease levels below 8000, followed by DEC as above		**[[Albendazole]] as above to decrease levels below 8000, followed by DEC as above
	**Apheresis to decrease levels below 8000, followed by DEC as above		**Apheresis to decrease levels below 8000, followed by DEC as above
			*[[Levamisole]] 0.25 mg/kg p.o. once is a promising new treatment<ref>Jérémy T Campillo, Paul Bikita, Marlhand Hemilembolo, Frédéric Louya, François Missamou, Sébastien D S Pion, Michel Boussinesq, CédricB Chesnais, Safety and Efficacy of Levamisole in Loiasis: A Randomized, Placebo-controlled, Double-blind Clinical Trial, ''Clinical Infectious Diseases'', Volume 75, Issue 1, 1 July 2022, Pages 19–27, https://doi.org/10.1093/cid/ciab906</ref>
	*Can consider concomitant [[antihistamines]] or [[corticosteroids]] during the first week of treatment to decrease symptoms associated with treatment		*Can consider concomitant [[antihistamines]] or [[corticosteroids]] during the first week of treatment to decrease symptoms associated with treatment

Aidan at 21:44, 11 September 2020

2020-09-11T21:44:33Z

← Older revision		Revision as of 21:44, 11 September 2020
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	==Background==		==Background==
	===Epidemiology===		===Epidemiology===

	* Transmitted by ''[[Chrysops silacea]]'' and ''[[Chrysops dimidiata]]'' flies		*Transmitted by ''[[Chrysops silacea]]'' and ''[[Chrysops dimidiata]]'' flies
			**Day biting flies, more common in rainy season and in rain forests
			**Attracted by fires and to rubber plantations
			*Present in West and Central Africa, primarily in Equatorial Guinea, Gabon, Cameroon, Central African Republic, Congo (Brazzaville), DRC, Nigeria, Chad, Sudan, Angola, Ethiopia

	==Clinical Manifestations==		==Clinical Manifestations==

	* Often asymptomatic		*Often asymptomatic
	* Most common symptom is '''Calabar swellings''', a 10- to 20-cm painful, itchy subcutaneous swelling caused by migration of the adult worms		*Most common symptom is '''Calabar swellings''', a 10- to 20-cm painful, itchy subcutaneous swelling caused by migration of the adult worms
	** The lesions are essentially angioedema in response to the worm		**The lesions are essentially angioedema in response to the worm
	* Worms can also migrate to the conjunctiva, where they are visible		*Worms can also migrate to the conjunctiva, where they are visible
	* Infection can be complicated by [[Causes::hematuria]] and [[Causes::proteinuria]]~~, as well as as [[Causes::encephalitis]], precipitated by treatment during high-level microfilaremia~~		*Infection can be complicated by [[Causes::hematuria]] and [[Causes::proteinuria]]

			=== Complications of Treatment ===

			* Treatment with antiparasitics may cause an increase in symptoms such as Calabar swellings or pruritis
			* With treatment of high-level parasitemia, can cause fatal encephalopathy

			== Diagnosis ==

			* Demonatration of microfilaria on Giemsa-stained blood film collected during daytime (10 am to 2 pm)
			** Also provides quantification of microfilarial burden

	==Management==		==Management==

⚫	* Must rule out high-level microfilaremia (>2500 microfilariae/mL) before considering medical treatment, due to the risk of ~~encephalitis~~
			*Not all infections require treatment
			*Before treatment
		⚫	**Must rule out high-level microfilaremia (>2500-8000 microfilariae/mL) before considering medical treatment, due to the risk of encephalopathy
			**Rule out [[Onchocerca volvulus]] coinfection, as treatment with DEC can lead to blindness or exacerbation of skin disease
			*If microfilaremia <8000 MF/mL
			**First-line treatment is [[diethylcarbamazine]] 8-10 mg/kg/day po divided tid for 21 days
			***Kills both the adult worms and microfilaria
			**After failing 2 rounds of DEC, [[albendazole]] 200 mg bid for 21 days
			*If microfilaremia ≥8000 MF/mL, either:
			**[[Albendazole]] as above to decrease levels below 8000, followed by DEC as above
			**Apheresis to decrease levels below 8000, followed by DEC as above
			*Can consider concomitant [[antihistamines]] or [[corticosteroids]] during the first week of treatment to decrease symptoms associated with treatment

	{{DISPLAYTITLE:''Loa loa''}}		{{DISPLAYTITLE:''Loa loa''}}

Aidan: Text replacement - "Clinical Presentation" to "Clinical Manifestations"

2020-07-23T12:37:05Z

Text replacement - "Clinical Presentation" to "Clinical Manifestations"

← Older revision		Revision as of 12:37, 23 July 2020
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	* Transmitted by ''[[Chrysops silacea]]'' and ''[[Chrysops dimidiata]]'' flies		* Transmitted by ''[[Chrysops silacea]]'' and ''[[Chrysops dimidiata]]'' flies

	==Clinical ~~Presentation~~==		==Clinical Manifestations==
	* Often asymptomatic		* Often asymptomatic
	* Most common symptom is '''Calabar swellings''', a 10- to 20-cm painful, itchy subcutaneous swelling caused by migration of the adult worms		* Most common symptom is '''Calabar swellings''', a 10- to 20-cm painful, itchy subcutaneous swelling caused by migration of the adult worms

Aidan at 23:18, 7 July 2020

2020-07-07T23:18:49Z

← Older revision		Revision as of 23:18, 7 July 2020
Line 12:		Line 12:
	==Management==		==Management==
	* Must rule out high-level microfilaremia (>2500 microfilariae/mL) before considering medical treatment, due to the risk of encephalitis		* Must rule out high-level microfilaremia (>2500 microfilariae/mL) before considering medical treatment, due to the risk of encephalitis

			{{DISPLAYTITLE:''Loa loa''}}

	[[Category:Nematodes]]		[[Category:Nematodes]]

Aidan: Created page with "==Background== ===Epidemiology=== * Transmitted by ''Chrysops silacea'' and ''Chrysops dimidiata'' flies ==Clinical Presentation== * Often asymptomatic * Most common..."

2020-07-07T23:18:29Z

Created page with "==Background== ===Epidemiology=== * Transmitted by ''Chrysops silacea'' and ''Chrysops dimidiata'' flies ==Clinical Presentation== * Often asymptomatic * Most common..."

New page

==Background==
===Epidemiology===
* Transmitted by ''[[Chrysops silacea]]'' and ''[[Chrysops dimidiata]]'' flies

==Clinical Presentation==
* Often asymptomatic
* Most common symptom is '''Calabar swellings''', a 10- to 20-cm painful, itchy subcutaneous swelling caused by migration of the adult worms
** The lesions are essentially angioedema in response to the worm
* Worms can also migrate to the conjunctiva, where they are visible
* Infection can be complicated by [[Causes::hematuria]] and [[Causes::proteinuria]], as well as as [[Causes::encephalitis]], precipitated by treatment during high-level microfilaremia

==Management==
* Must rule out high-level microfilaremia (>2500 microfilariae/mL) before considering medical treatment, due to the risk of encephalitis

[[Category:Nematodes]]
[[Category:Infectious diseases]]