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Extradural Guinea-Worm Abscess

REPORT OF TWO CASES

Dracunculiasis occurs commonly in and around Kurnool, owing to the fetching of water from tanks and from step-wells into which one must descend. In some areas around Kurnool from 50 to 70% of the people have at one time been infected with guinea worm. Usually in these patients the worm emerges from the center of a bleb, but Dracunculus medinensis may also be seen as a calcified thread-like or whorled shadow on X-ray, around the bladder, thigh muscles, knee joint, or at times in the chest wall. There also may be tumor-like swellings in various parts of the body; such a tumor, if superficial, may be of long duration. The worm has been found around the knee joint, causing arthritis, as a tumor-like swelling in the subcutaneous tissues or muscle, and in unexpected areas as well, such as the eye and the extradural space. In these deeper tissues the lesion causes pressure symptoms and even death.