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 hematuria and proteinuria, as well as as 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
References
^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. 2021;75(1):19-27. doi:10.1093/cid/ciab906.
