Diagnosis and Treatment of Acanthocheilonema Perstans Filariasis

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An analysis of 61 patients, 34 known to be infected with Acanthocheilonema perstans and the others presumed to be infected with A. perstans or some other type of filaria, has been made. Seventeen patients exhibited symptoms which are believed to be attributable to A. perstans as microfilariae of A. perstans were demonstrated in their blood and all tested were positive by serologic tests. Fourteen who were symptomatic had no microfilariae in the blood but 12 of 13 tested were positive by serologic tests. Seventeen who were asymptomatic had microfilariae of A. perstans in the blood and all tested by serologic tests were positive. Thirteen were asymptomatic, had no microfilariae in their blood, and 12 of 13 were positive by serologic test. Approximately 50% of the entire group showed symptoms regarded as representing clinical filariasis. Serious symptoms were present in about 9% of the cases. Microfilariae of A. perstans were demonstrable in slightly more than half the cases of both the symptomatic and asymptomatic groups.

While unevaluated to date, the serologic tests for filariasis employed in this study (hemagglutination and bentonite flocculation tests) have been useful in arriving at a diagnosis of clinical filariasis. In addition, diethylcarbamazine therapy has in some instances helped clarify the diagnosis of infection with A. perstans through the provocation of symptoms and initial appearance of microfilariae in the blood followed by the resolution of symptoms under treatment. In most instances apparent recovery followed the administration of diethylcarbamazine. Case histories are given illustrating clinical manifestations of infection with A. perstans.

Author Notes

Chicago Missionary Medical Office, Chicago, Illinois.

United States Public Health Service, Communicable Disease Center, Atlanta, Georgia.

Chicago Medical School, Mount Sinai Hospital, Chicago, Illinois.