Scrotal filariasis

Dr Aditya Shetty et al.

Scrotal filariasis is a manifestation of filariasis and refers to scrotal involvement from parasites that come under the family name filariodidea.

Known disease of the tropics and sub-tropics and a cause of morbidity across Asia, Africa and the western Pacific regions 2.

Patients may be asymptomatic or present with fever or scrotal swelling. ​

Aetiology

Filarial parasites are transmitted via mosquito bite to humans. Parasite invades the skin and then the lymphatics where they forms nests and multiply.

Lymphatic filariasis is transmitted by different types of mosquitoes:

  • Culex mosquito: widespread across urban and semi-urban areas
  • Anopheles: mainly in rural areas
  • Aedes: mainly in endemic islands in the Pacific

Lymphatic filariasis is caused by infection with nematodes (roundworms) of the family Filariodidea. There are three types of these thread-like filarial worms:

  • Wuchereria bancrofti: responsible for 90% of cases
  • Brugia malayi: causes most of the remainder of cases
  • B. timori: also causes the disease

Adult worms lodge in the lymphatic system and disrupt the immune system.

Ultrasound

Dilated lymphatic channels (average diameter 6 mm) containing curvilinear echogenic undulating structures representing the microfilariae (usually 5-6) exhibiting the characteristic "filarial dance sign".

The parasites may affect the scrotum unilaterally or bilaterally and cause an associated hydrocoele.

Treatment options include diethylcarbamazine (DEC) 6mg/kg body weight in combination with albendazole.

Complications

Grossly dilated lymphatics and oedema progressing to elephantiasis.


Ultrasound - general index
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Article Information

rID: 26948
System: Urogenital
Section: Pathology
Synonyms or Alternate Spellings:
  • Filariasis involving the scrotum
  • Filariasis of the scrotum

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