1921
Volume 81, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

A retrospective study was undertaken in Recife, Brazil to evaluate the specificity of intrascrotal nodules detected by physical examination as a marker of dead or degenerating adult worms (filarial granuloma). A total of 372 nodules from 340 adult male patients (mean age 23.1 years) were studied. Of those, 253 (68%) nodules were from 226 patients treated with antifilarial drugs (Group 1) and 119 (32%) nodules were considered non-drug related and were obtained from 114 patients (Group 2). On histologic examination, all nodules from Group 1 and all but one (99.1%) from Group 2 contained degenerated or dead adult worms. In the one case without filarial granuloma, ectopic cortical adrenal tissue was found in the spermatic cord. These findings emphasize the high specificity of intrascrotal nodules for bancroftian granuloma and draw attention to the importance of examining the scrotal contents of young men in studies of antifilarial drug efficacy. These findings also have potential implications for bancroftian filariasis control programs.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.2009.81.317
2009-08-01
2019-07-19
Loading full text...

Full text loading...

/deliver/fulltext/14761645/81/2/0810317.html?itemId=/content/journals/10.4269/ajtmh.2009.81.317&mimeType=html&fmt=ahah

References

  1. Santiago-Stevenson D, Oliver-González J, Hewitt RI, 1947. Treatment of filariasis bancrofti with 1-diethylcarbamyl-4-methylpiperazine hydrochoride (“Hetrazan”). JAMA 135 : 708–712. [Google Scholar]
  2. Galliard H, 1971. Effects of diethyl-carbamazine on lymphatic filariosis at the beginning of the prophylactic campaign in Tahiti. Bull Soc Pathol Exot Filiales 64 : 340–343. [Google Scholar]
  3. Galliard H, Mille R, 1949. Essais de traitement de la filariose à Wuchereria bancrofti var. pacifica par le 1-diéthyl-carbamyl-4-méthyl pipérazine, à Tahiti. Bull Soc Pathol Exot 42 : 304–313. [Google Scholar]
  4. Ch’en T-T, 1964. Demonstration of macrofilaricidal action of hetrazan, antimony and arsenic preparations in man. Chinese Med J 83 : 625–640. [Google Scholar]
  5. Ch’en T-T, Ch’en C-T, Hsü F-Y, Hsü C-K, Lo H-M, Hsü H-C, Yang C-L, Hu M-T, Shih H-L, 1959. Preliminary observations on intensive Hetrazan treatment of filariasis. Chin Med J 78 : 174. [Google Scholar]
  6. Jungmann P, Figueredo-Silva J, Dreyer G, 1992. Bancroftian lymphangitis in northeastern Brazil: a histopathological study of 17 cases. J Trop Med Hyg 95 : 114–118. [Google Scholar]
  7. Dreyer G, Pires ML, Andrade LD, Lopes E, Medeiros Z, Tenorio J, Coutinho A, Norões J, Figueredo-Silva J, 1994. Tolerance of diethylcarbamazine by microfilaraemic and amicrofilaraemic individuals in an endemic area of bancroftian filariasis, Recife, Brazil. Trans R Soc Trop Med Hyg 88 : 232–236. [Google Scholar]
  8. Dreyer G, Coutinho A, Miranda D, Norões J, Rizzo JA, Galdino E, Rocha A, Medeiros Z, Andrade LD, Santos A, Figueredo-Silva J, Ottesen EA, 1995. Treatment of bancroftian filariasis in Recife, Brazil: a two year comparative study of the efficacy of single treatments with ivermectin or diethylcarbamazine. Trans R Soc Trop Med Hyg 89 : 98–102. [Google Scholar]
  9. Figueredo-Silva J, Jungmann P, Norões J, Piessens WF, Coutinho A, Brito C, Rocha A, Dreyer G, 1996. Histological evidence for the adulticidal effect of low doses of diethycarbamazine in bancroftian filariasis. Trans R Soc Trop Med Hyg 90 : 192–194. [Google Scholar]
  10. Rocha A, Addiss D, Ribeiro ME, Norões J, Baliza M, Medeiros Z, Dreyer G, 1996. Evaluation of the Og4C3 ELISA in Wuchereria bancrofti infection: infected persons with undetectable or ultra-low microfilarial densities. Trop Med Int Health 1 : 859–864. [Google Scholar]
  11. Norões J, Dreyer G, Santos A, Mendes VG, Medeiros Z, Addiss D, 1997. Assessment of the efficacy of diethylcarbamazine on adult Wuchereria bancrofti in vivo. Trans R Soc Trop Med Hyg 91 : 78–81. [Google Scholar]
  12. Dreyer G, Addiss D, Santos A, Figueredo-Silva J, Norões J, 1998. Direct assessment in vivo of the efficacy of combined single-dose ivermectin and diethylcarbamazine against adult Wuchereria bancrofti. Trans R Soc Trop Med Hyg 92 : 219–222. [Google Scholar]
  13. Dreyer G, Medeiros Z, Netto MJ, Leal NC, De Castro LG, Piessens WF, 1999. Acute attacks in the extremities of persons living in an area endemic for bancroftian filariasis: differentiation of two syndromes. Trans R Soc Trop Med Hyg 93 : 413–417. [Google Scholar]
  14. Dreyer G, Santos A, Norões J, Addiss D, 1999. Proposed panel of diagnostic criteria, including the use of ultrasound, to refine the concept of “endemic normals” in lymphatic filariasis. Trop Med Int Health 4 : 575–579. [Google Scholar]
  15. Figueredo-Silva J, Norões J, Cedenho A, Dreyer G, 2002. The histopathology of bancroftian filariasis revisited: the role of the adult worm in the lymphatic-vessel disease. Ann Trop Med Parasitol 96 : 531–541. [Google Scholar]
  16. Norões J, Addiss D, Cedenho A, Figueredo-Silva J, Lima G, Dreyer G, 2003. Pathogenesis of filarial hydrocele: risk associated with intrascrotal nodules caused by death of adult Wuchereria bancrofti. Trans R Soc Trop Med Hyg 97 : 561–566. [Google Scholar]
  17. Figueredo-Silva J, Dreyer G, 2005. Bancroftian filariasis in children and adolescents: clinical-pathological observations in 22 cases from an endemic area. Ann Trop Med Parasitol 99 : 759–769. [Google Scholar]
  18. Figueredo-Silva J, Norões J, Addiss D, Dreyer G, 2008. Sex ratio of Wuchereria bancrofti in surgical specimens from an endemic area of Brazil. Ann Trop Med Parasitol 102 : 229–238. [Google Scholar]
  19. Dreyer G, Lins R, Norões J, Rizzo JA, Figueredo-Silva J, 2008. Sensitivity of the ICT test relative to detection of adult Wuchereria bancrofti worms by ultrasound. Am J Trop Med Hyg 78 : 28–34. [Google Scholar]
  20. Norões J, Addiss D, Amaral F, Coutinho A, Medeiros Z, Dreyer G, 1996. Occurrence of living adult Wuchereria bancrofti in the scrotal area of men with microfilaremia. Trans R Soc Trop Med Hyg 90 : 55–56. [Google Scholar]
  21. Norões J, Addiss D, Santos A, Medeiros Z, Coutinho A, Dreyer G, 1996. Ultrasonographic evidence of abnormal lymphatic vessels in young men with adult Wuchereria bancrofti infection in the scrotal area. J Urol 156 : 409–412. [Google Scholar]
  22. Reddy GS, Das LK, Pani SP, 2004. The preferential site of adult Wuchereria bancrofti: an ultrasound study of male asymptomatic microfilaria carriers in Pondicherry, India. Natl Med J India 17 : 195–196. [Google Scholar]
  23. Michael E, Bundy DAP, Grenfell BT, 1996. Re-assessing the global prevalence and distribution of lymphatic filariasis. Parasitology 112 : 409–428. [Google Scholar]
  24. Dreyer G, Norões J, Figueredo-Silva J, Piessens WF, 2000. Pathogenesis of lymphatic disease in bancroftian filariasis: a clinical perspective. Parasitol Today 16 : 544–548. [Google Scholar]
  25. Dreyer G, Addiss D, Norões J, Amaral F, Rocha A, Coutinho A, 1996. Ultrasonographic assessment of the adulticidal efficacy of repeat high-dose ivermectin in bancroftian filariasis. Trop Med Int Health 1 : 427–432. [Google Scholar]
  26. Dreyer G, Norões J, Amaral F, Nen A, Medeiros Z, Coutinho A, Addiss D, 1995. Direct assessment of the adulticidal efficacy of single dose ivermectin in bancroftian filariasis. Trans R Soc Trop Med Hyg 89 : 441–443. [Google Scholar]
  27. Dreyer G, Addiss D, Williamson J, Norões J, 2006. Efficacy of co-administered diethylcarbamazine and albendazole against adult Wuchereria bancrofti. Trans R Soc Trop Med Hyg 100 : 1118–1125. [Google Scholar]
  28. Ottesen EA, 1985. Efficacy of diethylcarbamazine in eradicating infection with lymphatic-dwelling filariae in humans. Rev Infect Dis 7 : 341–356. [Google Scholar]
  29. Amaral F, Dreyer G, Figueredo-Silva J, Norões J, Cavalcanti A, Samico SF, Santos A, Coutinho A, 1994. Live adult worms detected by ultrasonography in human bancroftian filariasis. Am J Trop Med Hyg 50 : 753–757. [Google Scholar]
  30. Kar SK, 1986. Atypical features in lymphatic filariasis. Indian J Med Res 84 : 270–274. [Google Scholar]
  31. Kar SK, Mania J, Kar PK, 1993. Prevalence of lymphatic nodule in a bancroftian endemic population. Acta Trop 55 : 53–60. [Google Scholar]
  32. Thooris GC, Heuls J, Kessel JF, L’hoiry, Bambridge B, 1956. Research on methods of diagnosis and treatment of filariosis due to Wuchereria bancrofti in French Oceania. Bull Soc Pathol Exot Filiales 49 : 1138–1157. [Google Scholar]
  33. Dreyer G, Santos A, Norões J, Rocha A, Addiss D, 1996. Amicrofilaraemic carriers of adult Wuchereria bancrofti. Trans R Soc Trop Med Hyg 90 : 288–289. [Google Scholar]
  34. Dreyer G, Figueredo-Silva J, Carvalho K, Amaral F, Ottesen EA, 2001. Lymphatic filariasis in children: adenopathy and its evolution in two young girls. Am J Trop Med Hyg 65 : 204–207. [Google Scholar]
  35. Dreyer G, Norões J, Addiss D, Santos A, Medeiros Z, Figueredo-Silva J, 1999. Bancroftian filariasis in a paediatric population: an ultrasonographic study. Trans R Soc Trop Med Hyg 93 : 633–636. [Google Scholar]
  36. Ottesen EA, Ismail MM, Horton J, 1999. The role of albendazole in programmes to eliminate lymphatic filariasis. Parasitol Today 15 : 382–386. [Google Scholar]
  37. Araújo AC, Figueredo-Silva J, Souto-Padron T, Dreyer G, Norões J, De Souza W, 1995. Scanning electron microscopy of adult Wuchereria bancrofti (nematoda: filarioidea). J Parasitol 81 : 468–474. [Google Scholar]
  38. Ramzy RM, Helmy H, el-Lethy AS, Kandil AM, Ahmed ES, Weil GJ, Faris R, 1999. Field evaluation of a rapid-format kit for the diagnosis of bancroftian filariasis in Egypt. East Mediterr Health J 5 : 880–887. [Google Scholar]
  39. Hussein O, El Setouhy M, Ahmed ES, Kandil AM, Ramzy RMR, Helmy H, Weil GJ, 2004. Duplex doppler sonographic assessment of the effects of diethylcarbamazine and albendazole therapy on adult filarial worms and adjacent host tissues in bancroftian filariasis. Am J Trop Med Hyg 71 : 471–477. [Google Scholar]
  40. Debrah AY, Mand S, Specht S, Marfo-Debrekyei Y, Batsa L, Pfarr K, Larbi J, Lawson B, Taylor M, Adjei O, Hoerauf A, 2006. Doxycycline reduces plasma VEGF-C/sVEGFR-3 and improves pathology in lymphatic filariasis. PLoS Pathog 2 : e92. [Google Scholar]
  41. Mand S, Supali T, Djuardi J, Kar S, Ravindran B, Hoerauf A, 2006. Detection of adult Brugia malayi filariae by ultrasonography in humans in India and Indonesia. Trop Med Int Health 11 : 1375–1381. [Google Scholar]
  42. Delmas V, Dauge MC, 1986. Accessory adrenals in the spermatic cord. Apropos of 2 cases. Ann Urol (Paris) 20 : 261–264 (Paris). [Google Scholar]
  43. Gualtieri T, Segal AD, 1949. Report of case of adrenal-type tumor of spermatic cord; A review of aberrant adrenal tissues. J Urol 61 : 949–955. [Google Scholar]
  44. Roca Suarez A, Alvarez Ossorio JL, Del Toro Bacerra JA, Maximiano Vasquez R, Gordon Laporte R, 1993. Adrenal ectopia in the spermatic cord. Actas Urol Esp 17 : 584–587. [Google Scholar]
  45. Mares AJ, Shkolnik A, Sacks M, Feuchtwanger MM, 1980. Aberrant (ectopic) adrenocortical tissue along the spermatic cord. J Pediatr Surg 15 : 289–292. [Google Scholar]
  46. Savas C, Candir O, Bezir M, Cakmak M, 2001. Ectopic adrenocortical nodules along the spermatic cord of children. Int Urol Nephrol 32 : 681–685. [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.2009.81.317
Loading
/content/journals/10.4269/ajtmh.2009.81.317
Loading

Data & Media loading...

  • Received : 18 Mar 2009
  • Accepted : 08 May 2009

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error