Filariasis differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]

Filariasis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Filariasis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
X Ray
CT Scan
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Filariasis differential diagnosis On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
slides
Images
American Roentgen Ray Society Images of Filariasis differential diagnosis All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Filariasis differential diagnosis
on Filariasis differential diagnosis
Filariasis differential diagnosis in the news
Blogs on Filariasis differential diagnosis
Directions to Hospitals Treating Filariasis
Risk calculators and risk factors for Filariasis differential diagnosis

Overview

Lymphatic filariasis must be differentiated from other causes of lower limb edema, such as chronic venous insufficiency, acute deep venous thrombosis, lipedema, myxedema, cellulitis and causes of generalized edema. Hydrocele sholud be differentiated from other causes of testicular masses. Breast lymphedema must be differentiated from breast cancer.

Differentiating filariasis from other diseases

Diseases	Symptoms							Signs	Gold standard Investigation to diagnose
	History	Onset	Pain	Fever	Laterality	Scrotal swelling	Symptoms of primary disease
Lymphatic filariasis	History of living in endemic area or travelling to it	Chronic	+	+	Bilateral	+	-	Hepatomegaly Lymphedema Elephantiasis Lymphangitis Hydrocele Scrotal elephantiasis Lymphadenopathies Rhonchi may be present in patients with Pulmonary tropical eosinophilia syndrome	Preparing Blood Smears Thick Smears Thick smears consist of a thick layer of dehemoglobinized (lysed) red blood cells (RBCs).Thick smears allow a more efficient detection of parasites (increased sensitivity). Thin Smears Thin smears consist of blood spread in a layer such that the thickness decrease. By the ultrasound, the following findings can be observed: Dilated lymphatic channels Living worms tend to be in motion which called "filarial dance" sign.
Chronic venous insufficiency	History of untreated varicose veins Painful bilateral lower limb swelling increase with standing and decreased by rest and leg elevation	Chronic	+	-	Bilateral	+ (If congenial , Venous insufficiency un testicular veins may form scrotal swelling)	-	Typical varicose veins Skin change distribution correlate with varicose veins sites in the medial side of ankle and leg Reduction of swelling with limb elevation.	Duplex ultrasound will demonstrate typical findings of venous valvular insufficiency
Acute deep venous thrombosis	History of prolonged recumbency Classic symptoms of DVT include acute unilateral swelling, pain, and erythema	Acute	+	-	Unilateral	-	May be associated with primary disease mandates recumbency for long duration	Positive Homan's sign	Compression ultrasonography (CUS) with Doppler is the diagnostic test of choice D-dimer is used for unprobable cases
Lipedema	Family history especially in women; X-linked dominant or autosomal dominant condition Abnormal deposition of fat and edema	Chronic	+	-	Bilateral	-	-	Tender with palpation
Myxedema	History of untreated hypothyroidism Infiltration of the skin with glycosaminoglycans with associated water retention	Chronic	+	-	Bilateral	-	+ (hypothyroidism )
Cellulitis	Acute painful swelling and may be fever	Acute	+	+	Unilateral	-	-	Tenderness,hotness and may be flactuation if abscess formed
Other causes of generalized edema	History of chronic general condition(cardiac-liver-renal)	Chronic	-	-	Bilateral	-	+		According to the primary cause ( Echo- LFT- RFT)