Onchocerciasis Presenting with Swelling of Limb

Martin S. Wolfe Tropical Medicine Unit, Office of Medical Services, Department of State, Geographic Pathology Division, Armed Forces Institute of Pathology, Washington, D. C. 20520

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Jack L. Petersen Tropical Medicine Unit, Office of Medical Services, Department of State, Geographic Pathology Division, Armed Forces Institute of Pathology, Washington, D. C. 20520

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Ronald C. Neafie Tropical Medicine Unit, Office of Medical Services, Department of State, Geographic Pathology Division, Armed Forces Institute of Pathology, Washington, D. C. 20520

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Daniel H. Connor Tropical Medicine Unit, Office of Medical Services, Department of State, Geographic Pathology Division, Armed Forces Institute of Pathology, Washington, D. C. 20520

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David T. Purtilo Tropical Medicine Unit, Office of Medical Services, Department of State, Geographic Pathology Division, Armed Forces Institute of Pathology, Washington, D. C. 20520

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DOI:
https://doi.org/10.4269/ajtmh.1974.23.361
Volume/Issue:
Volume 23: Issue 3
Page(s):
361–368
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Two Americans, after returning from Africa, developed swelling of a limb. Both patients had pruritus of the swollen limb, enlargement of the regional lymph nodes, transient discrete macular or papular eruptions, eosinophilia, positive serologic findings from tests for filarial antibodies, and microfilariae of Onchocerca volvulus in the skin. Subcutaneous nodules, generalized papular rash, and ocular changes were absent. Pretreatment biopsy specimens of skin revealed eosinophils around vascular channels, focal edema of the dermal collagen, and in one patient a degenerating microfilaria surrounded by the granules of degenerating eosinophils. These changes were intensified following administration of diethylcarbamazine. We think the swelling and the marked inflammatory response was a hypersensitive reaction to an antigenic product of dying microfilariae. Serum immunoglobulins were measured in one patient, and only IgE was found to be elevated. An attempt to detect immunoglobulins, including IgE, in the skin with a direct immunofluorescence technique was unsuccessful.
Copyright:
Copyright © 1974 by The American Society of Tropical Medicine and Hygiene 1974
Accepted:
10 Nov 1973
|
Published Online:
May 1974
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
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