A patient with filariasis involving an extremity often develop acute lymphatic disease. It is important to distinguish the common bacterial lymphangitis from that associated with the filarial worms. The authors are from Recife, Brazil, and the Harvard School of Public Health.
ADLA = acute dermatolymphangioadenitis, associated with bacterial cellulitis
AFL = acute filarial lymphadenitis, associated with reaction to the death of an adult worm.
|
Feature |
Acute Bacterial ADLA |
Acute Filarial Lymphangitis |
|
frequency |
common |
uncommon |
|
sites of involvement |
almost always legs, usually distal |
may involve legs, arms or breast, often proximal |
|
presentation |
plaque like lesion |
isolated nodule, or cord-like palpable lesion |
|
inflammation |
diffuse subcutaneous (cellulitis) |
confined to lymphatic or lymph node |
|
lymphangitis |
ascending |
descending or centrifugal |
|
satellite lymphadenopathy |
may occur |
rare |
|
can identify an entry lesion |
common, often between the toes or elsewhere on the foot |
rare |
|
distal edema |
common, often with residual edema |
rare |
|
systemic symptoms |
common and prominent, may be severe |
none or mild |
|
previous episodes |
common |
uncommon |
|
improves with better hygiene |
yes |
no |
|
progression to elephantiasis |
common |
uncommon |
|
exfoliative dermatitis |
common |
uncommon |
from Table 1, page 414
Specialty: Infectious Diseases
ICD-10: ,
