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PubMed2003

Prevalence of podoconiosis (endemic non-filarial elephantiasis) in Wolaitta, Southern Ethiopia.

The survey was undertaken to establish the point prevalence of overt podoconiosis (endemic non-filarial elephantiasis) in Wolaitta zone, Southern Ethiopia, and also to determine whether age- or sex-related prevalence differences exist. A cross-sectional survey was performed during May-September 2001 among 33 678 residents of 4210 households randomly selected from all seven woredas (administrative districts) of Wolaitta zone. Trained data collectors administered a simple questionnaire and examined household residents for signs of podoconiosis. Of the residents 1890 had overt signs of podoconiosis. The mean zonal prevalence weighted for the woreda size was 5.46%. Most of cases (64%) occurred in the economically productive age groups (16-45 years). The male:female ratio was 1:0.98, reflecting the gender ratio of the zone. Podoconiosis is an important chronic public health problem affecting both men and women in areas of irritant soil. Further research is necessary to establish the economic effects of the condition.

Adolescent↗
PubMed2002

Reactivity to bacterial, fungal, and parasite antigens in patients with lymphedema and elephantiasis.

Both secondary infections and antifilarial immunity are thought to play roles in the development and progression of lymphedema. To investigate this issue, immune responses to a panel of bacterial, fungal, and parasite antigens were examined for women with lymphedema and elephantiasis (n = 28) and for women with no clinical evidence of lymphatic dysfunction who were either microfilaremic (Mf+, n = 23) or microfilaria- and filarial antigen-negative (Ag-, n = 24). The prevalence and intensity of delayed-type hypersensitivity (DTH) responses was similar for most recall antigens; for individual antigens, lymphedema patients were significantly more likely to be reactive only to Proteus. Lymphedema patients with a history of three or more attacks of adenolymphangitis in the last 18 months showed increased DTH reactivity to Trichophyton. Proliferative responses to fungal and bacterial antigens were similar for all three groups; however, antigen-negative women, independent of disease status, mounted greater responses to filarial antigen. In contrast, lymphedema patients had higher levels of antifilarial specific IgG1, IgG2, and IgG3 and higher IgG responses to streptolysin O than either Ag- or Mf+ women. In persons with lymphatic filariasis, immune reactivity is influenced by disease status as well as infection status.

Adolescent↗
PubMedDate not supplied

Elephantiasis nostras verrucosa.

Swelling of the leg is a frequent finding in podiatric medicine. Unless the patient draws notice to the condition or the physician is diligent in asking questions and examining the extremity, the condition may be viewed as minor and given little attention. Swelling of the leg can be a clinical sign of certain systemic diseases, lymphatic and venous disorders, or other miscellaneous causes. Dermatologic consequences linked to many of these causes of swelling are well documented. What is not as well chronicled is a dramatic skin alteration associated with chronic lymphedema. This article provides an overview and a case presentation of the unusual and debilitating skin condition related to chronic lymphedema of the lower extremity known as elephantiasis nostras verrucosa.

Elephantiasis↗
PubMed1995

Chronic elephantiasis. A case report.

The authors presented a rare case study of a patient with chronic elephantiasis involving the lower extremities. The patient had contracted lymphatic filariasis while serving in the armed forces during World War II. The patient was followed regularly for local wound care by the Veterans Affairs podiatry department. However, he died from congestive heart failure and pneumonia in May of 1993.

Aged↗
PubMed2000

[Elephantiasis soon eliminated? New therapeutic concepts make mass treatment possible].

Lymphatic filariasis currently affects some 120 million people in 73 tropical countries. Almost one-half of all those affected have manifest signs and symptoms of disease, of which elephantiasis is the most serious. A large majority of the remainder have subclinical lymphopathy and nephropathy. New scientific discoveries give rise to the hope that the global elimination of this disease--which is associated with physical disfigurement, sexual dysfunction and social decline--might be possible. Today, we have available simple diagnostic tools and highly effective, safe and cost-effective medications. New insights into the pathogenesis now make it possible to alleviate individual suffering and prevent further progression of the disease.

Albendazole↗
PubMed2001

Neurofibromatosis, gigantism, elephantiasis neuromatosa and recurrent massive subperiosteal hematoma: a new case report and review of 7 case reports from the literature.

The authors report the case of a 13-year-old patient with neurofibromatosis (NF-I), who suffered blunt trauma to the left tibia in 1993. The diagnosis of subperiosteal hematoma was made. Treatment consisted of temporary rest. There was a recurrence in 1996, and the subperiosteal hematoma was drained. In 1997, a shortening osteotomy of the left tibia was performed. However, massive gigantism with elephantiasis of the left leg remained, causing a serious functional and cosmetic problem. In 1999, the leg was amputated above the knee. The literature is reviewed and 7 case reports are compared. The pathogenesis of subperiosteal hematoma is discussed.

Adolescent↗
PubMed2004

[Scrotal elephantiasis: about seven operated cases].

The authors report seven cases of scrotal elephantiasis operated on nine years in the urology department of a filarial endemic zone. Patients wait for a long time before consulting for big scrotum reaching eventually 15 kg. The final arguments for the filarial origin haven't been found whereas arguments of presumption exist The surgical treatment has enabled to get an aesthetic satisfying result, sometimes after a second cure.

Adult↗
PubMed2005

[Lymphatic filariasis in Republic of Congo and scrotal elephantiasis].

Cases of scrotal elephantiasis operated in the Brazzaville' hospital are naturally imputed to Wuchereria bancrofti, in spite of the absence of parasitological proof. This is due to the fact that data's diffused by WHO which are widely included in the literature, unfortunately present this filariasis as being endemic in the Republic of Congo. But it is impossible to identify what works are at the origin of this assertion during the 30 last years. What is certain, it is that no case of lymphatic filariasis was found at the time of the field surveys carried out on filariasis both in the Congo and in Gabon, country also presented as an endemic territory, at the end of the Seventies and during the Eighties. These works were unfortunately published in French. Since this time no publication related a fieldwork or a conclusive clinical observation has confirmed the presence of Wuchereria bancrofti in these two countries of Central Africa.

Animals↗
PubMed1991

[Elephantiasis nostras. A rare complication to erysipelas].

A case of elephantiasis nostras in a lower limb is presented. A thorough programme of investigation could only reveal a single episode of erysipelas as the possible etiological origin. The therapeutic possibilities are briefly reviewed. The most important are early institution of adequate antibiotic treatment and antibiotic treatment of every recurrence of disease.

Adult↗
PubMed1991

[Voluminous elephantiasis of both legs treated by the Gibson's procedure].

The diagnosis of elephantiasis of both lower limbs was made in a 39 year old woman after a fourteen year history of essential lymphoedema accompanied by hypoproteinaemia of 37 g/l. Complete excision of the diseased tissues was performed from the knees down with resection of the aponeuroses and cover by skin grafts raised from the legs at the start of the operation. A good result was observed after three years. After reviewing the literature, the authors recall the essential features of primary lymphoedema of the lower limbs.

Adult↗
PubMed1989

[Elephantiasis of the vulva and the legs. Medical and surgical treatment of a case of lymphatic filariasis].

After reviewing the main causes of elephantiasis in tropical countries, the results of combined medical and surgical treatment of a case of lymphatic filariasis are reported. Medical treatment consists of a cycle of high-dose mebendazole (40 mg/kg/die) and subsequent cycles of diethylcarbamazine at a habitual dose (6 mg/kg/die). In the interval, the elephantiasic right lip was removed surgically. The overall clinical results was good. Noteworthy was an unwanted, leukopenising side-effect of high-dose mebendazole.

Adult↗
PubMed1989

[Verrucous elephantiasis: a maximum variant of lymphedema].

Verrucous elephantiasis is a special form of stage III lymphedema. Extensive deformation may cause immobility, and recurrent infections may be dangerous to life. Even in serious cases, conservative treatment (complex physiotherapy) may prove to be very successful. Surgery is not indicated as a treatment of first choice, but it may be very helpful in addition to physiotherapy.

Aged↗
PubMed1987

Subcutaneous phycomycosis mimics elephantiasis.

A case of subcutaneous phycomycosis involving the right thigh for 1 year duration which mimic elephantiasis was reported in a 21-year-old military man. An initial diagnosis was that of a subcutaneous tissue lesion attributed to parasitic manifestation but turned out to be that of subcutaneous fungal infection both clinically and histologically. The lesion was successfully treated with cotrimoxazole for a period of one month, and followed up for 4 1/2 months with complete cure.

Adult↗
PubMed1974

The relationship between endemic elephantiasis of the lower legs and the local soils and climate.

The prevalence of endemic elephantiasis of the lower legs in relation to the red soil on which the barefooted population lives has been investigated. Counts of 43,573 adults attending weekly markets have been made in ten markets of which five were on the red soil, two were on the limits of the soil, and three were at a distance from this area. Prevalence falls from a maximum of 6.92% on the red soil area, to 2.96% at the limit and to 0.98% in two directions within 25 km of the edge of the red soils. There is an association between the degree of prevalence and residence on the red soils. This is discussed and the possibility of a chemical irritant absorbed in colloid form through the bare feet is suggested as an etiological factor in the disease.

Elephantiasis↗
PubMed1981

The long term effects of repeated diethylcarbamazine administration with special reference to microfilaraemia and elephantiasis.

The result of mass treatment with 50 mg diethylcarbamazine (DEC) per kg body weight followed by two annual selective retreatments in an area highly endemic for Brugia timori infections are described. The criteria for selective re-treatment are simple and practical for use in rural areas. An education programme was developed which focused on describing the relationship between adenolymphangitis and filarial infections, the danger of repeated attacks and the efficiency of DEC in eliminating these attacks. Motivated persons in the community were charged with the responsibility of promptly treating all cases with acute clinical manifestations. With this programme the microfilaria rate by finger prick decreased from 24% to 0%, and by Nuclepore filtration from 30% to 5%. The adenolymphangitis rate decreased from 46% to 11% and the "elephantiasis' rate from 17% to 4%.

Adolescent↗
PubMed1984

Environmental factors in the etiology of endemic elephantiasis of the lower legs in tropical Africa.

The environmental factors including geography, geology and soil have been reviewed in areas of high prevalence of non-filariasis endemic elephantiasis surveyed in tropical Africa. These areas occur at altitudes above 1000 m where rainfall is seasonal and exceeds 1000 mm annually. The soil is a red clay, very slippery when wet and very adhesive if allowed to dry on the skin. These are also areas of past or present alkalic volcanism, the prevalence being highest in proximity to the volcanoes. The derived soils are notable for the high proportion of alumino-silicate particles of colloid size in the clays. The significance of these findings suggests that the number and small size of the clays. The significance of these findings suggests that the number and small size of the particles facilitates entry through the skin into the lymphatic tissues, where they exert the known irritant and fibrosing effects of silica and alumina.

Africa↗