1974 



DISEASES OF CONNECTIVE TISSUES 



DUBINI'S FILARIASIS. 



Definition. — Dubini's filariasis is a dermo-conjunctival filariasis 

 caused by Filaria conjunctives Addario, 1885. 



History. — The immature female worm was originally discovered 

 by Dubini in the subconjunctival tissue of a man in Milan, and is 

 possibly the same as that described as Agamofilaria oculi humani 

 von Nordmann, 1832, and as Agamofilaria palpehralis Pace, 1867, 

 nec Wilson, 1844. In 1880 Babes found another immature female 

 worm in a calcified nodule in the gastro-splenic omentum of a woman 

 in Budapest. He named it Filaria peritonei hominis. In 1885 

 Addario named a female worm extracted by Vadela from the con- 

 junctiva F. conjimctivcB. Vadela's case was a woman from Catania 

 in Sicily. In 1887 Grassi gave a full description of the female 

 worm, calling it F. inermis, because of the absence of papillae on the 

 head. In 1906 Alessandrini found it in an abscess in subcutaneous 

 tissue of the arm; and in 1918 Graham Forbes met with two cases in 

 the subcutaneous tissue of the forearm and of the nose, and was 

 the first to describe the adult male. 



It is the same as the worm called Filaria papulosa Rivolta, found 

 in the eye of an ass at Pisa, and also F. apapillocephala Condorelli- 

 Francaviglia. 



Climatology. — ^The worm is found in Italy, Sicily, Hungary, 

 Macedonia, and Roumania. It is a parasite of the horse and ass, 

 and but rarely of man. 



etiology. — It has been suggested that the worm is introduced 

 by the bites of Chrysops excutiens. 



Morbid Anatomy. — The nodule containing the worm consists of 

 fibrous connective tissue with round-celled infiltration and traversed 

 by lymph spaces. 



Pathology. — It is thought that the worm enters a lymphatic 

 canal, which becomes cut off and is surrounded by an inflammatory 

 reaction. No microfilariae can be found in the blood or in the 

 nodules. 



Symptomatology. — Marks of a bite have been seen in only one 

 case. Usually it is a small tumour in some area of the body which 

 is the first sign to attract attention. 



The differential blood count is as follows: — 



Per Cent. 



Polymorphonuclear leucocytes . . . . . . 47'0 



Mononuclear leucocytes . . . . . . . • iO'5 



Small lymphocytes . . . . . . ^ . . . 38*0 



Eosinophile leucocytes . . . . . . • • 3*5 



Basophile leucocytes . . . . . . . . . • i 'O 



As time progresses the little lump may become hot and swollen, 

 but not painful. After these inflammatory symptoms have lasted 

 for some three days they subside, only, however, to recur again in 

 about ten to fourteen days, and this cycle recurs and recurs. Some- 



