THE FILARIASES 



FILARIAL LYMPHANGITIS. 



Synonyms, — ^Elephant oid fever, Liliwa (Fijian term for a rigor), 

 fever and ague (Barbados). 



Definition. — ^^Filarial lymphangitis is an inflammation of lymphatic 

 vessels in any part of the body caused by Filaria hancrofti. 



Remarks. — ^Attacks of lymphangitis, associated with an erysipe- 

 latous eruption of the skin, are extremely common in the tropics, 

 and are often of a filarial nature, and by their repeated recurrences 

 produce elephantiasis. 



Symptomatology.— The attack often begins with a shivering fit, 

 and a rise of temperature to any degree from ioi° to 104^ F., with 

 vomiting and headache. In some cases there is no pain in the 



^ (0/' 



11 



Fig. 713, 



-Temperature Chart of a Case of Elephantiasis of the Leg 

 DURING AN Attack of Filarial Fever. 



affected area, but a careful examination, or the sensation of pain on 

 the part of the patient, will lead to the discovery of a red oedema- 

 tous area of skin, from which the inflamed lymphatic may be noted 

 extending towards the nearest lymphatic glands, which may or may 

 not be inflamed and painful. Usually the temperature falls quickly 

 in a couple of days to normal, and does not rise again, though it 

 may be several days before the erysipelatous rash disappears and 

 the lymphatics return to normal. 



Complications. — Rarely does this condition go on to abscess, 

 which may be caused by a dead filarial worm or a secondary infection. 



Sequelae. — Sometimes, after the acute inflammation has subsided, 

 a lymphatic can be felt as a hardened cord, which, if excised, will 

 be found to contain adult Filarial. 



. Diagnosis. — The only condition which could reasonably be mis- 

 taken for this affection is a caterpillar sting, which closely resembles 

 it in all details. The history of the case will indicate the correct 

 diagnosis. 



Treatment. — ^The treatment consists of rest in bed, a mild purga- 

 tive, and a little phenacetin and caffeine to relieve the headache, 

 while some of the old authors advise arsenic or tinctura ferri per- 



