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Human Streptocerciasis

A Clinico-Pathologic Study of 40 Africans (Zairians) Including Identification of the Adult Filaria^*

Wayne M. Meyers, Daniel H. Connor, Louis E. Harman, Keith Fleshman^||, Roger Moris^|| AND Ronald C. Neafie

Forty patients with streptocerciasis were studied. They lived in a small village near Mbandaka in the Republic of Zaire. Microfilariae of Dipetalonema streptocerca were present in the dermal collagen, and the features which distinguish these microfilariae are described and illustrated. The main clinical feature was a dermatitis characterized by pruritus, hypopigmented macules and papules. Microscopically there was incontinence of melanin, fibrosis of dermal papillae, dermal fibrosis, dilated dermal lymphatics, increased mucosaccharides around small dermal vessels and lymphocytes, and eosinophils around dermal appendages and vessels. Adult, gravid D. streptocerca were found for the first time in human tissue. They were in the dermis. Treatment with diethylcarbamazine aggravated the dermatitis and caused a reaction around the adult worms. The inguinal lymph nodes were fibrotic, had decreased germinal activity, marked histiocytic hyperplasia, dilated lymphatics, and were infiltrated by plasma cells and eosinophils. The finding of obstructive lymphadenitis suggests that streptocerciasis may be a factor in the pathogenesis of chronic lymphedema.

Accepted for publication April 12, 1972.

^* This study was supported by the following: Project Numbers DADA 17-70-G-9318, 3A014501B71Q, and DADA 17-68-G-09271 from the Medical Research and Development Command, U. S. Army, Washington, D. C.; The American Leprosy Missions, Inc., New York; The United Christian Missionary Society, Indianapolis, Indiana; and Assistance Technique Belge, Brussels, Belgium.

The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.

We gratefully acknowledge the permission and assistance of the Republic of Zaire in the performance of this study.

Institut Médical Evangélique, Kimpese, Republic of Zaire (formerly Democratic Republic of Congo).

Geographic Pathology Division, Armed Forces Institute of Pathology, Washington, D. C. 20305.

Department of Dermatology, Walter Reed General Hospital, Washington, D. C. 20012.

^|| Iyonda Leprosarium, via Mbandaka, Republic of Zaire.