Elephantitis is characterized by abnormal swelling of tissues and the skin in the lower portion of the body. The main target organs are legs and genitals which become thick and baggy making it difficult for the affected person to lead life normally. There will be excess of fluid collection on the legs and lower trunk making the skin dark and ulcerated. In medical terms, this disease is called as lymphatic filariasis since it is caused by filarial spreading mosquito. In severe cases, there can be serious complications causing damage to the blood vessels and may be life-threatening.
Lymphatic filariasis is caused by Wuchereria bancrofti, a parasite that is being carried by mosquito. These microorganisms are like round-worms and get transmitted into the human body when the mosquito bites the person. They enter the lymphatic vessels causing abnormal swelling of tissues and skin and in rare cases, can damage the blood vessels. Parasites belonging to the group Brugia malayl and Brugia timori may also cause this disease. The inflammation can be due to the response of the body’s immune system to the parasite.
The lymph flow of blood gets affected when there is obstruction in the lymph. Owing to the blockage, there may be inflammation of blood vessels causing back pressure which would dilate the superficial vessels causing more swelling.
Non-filarial elephantiasis is non-parasitic and is caused by the exposure to intense form of volcanic ashes. People who walk barefoot on the soil may receive the poisonous chemicals present in the soil which would eventually affect the lymphatic system and cause swelling.
Hereditary lymph edema is inherited by birth in which the lymph vessels become swollen due to accumulation of fluid.
Abnormal swelling of skin and tissues, thickening and darkening of the skin in the lower extremes, pain in the testicles, fever and enlargement of lymph nodes in the groin are some of the common symptoms. Excess of fluid gets accumulated in the tissues of legs (edema) causing inflammation and pain. The skin on the legs gets pebbly appearance with discharge of liquids along with pain and discomfort.
In case of chronic infection, it can affect other organs like liver and spleen making it enlarged. The legs and genitals become massively swollen. For males, the scrotum gets abnormally enlarged and penis may get retracted under the thickened skin. In female, the vulva may be affected and a huge mass of thick layer of skin may be seen growing between the thighs. The lymph nodes of the legs get enlarged.
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Elephantitis infection can be treated with antibiotics for destroying the growth of parasite present in the lymphatic vessels. Drugs like lyermectin, diethlycarbamazine, suramin and metrifonate are given. Some doctors also prescribe doxycycline for controlling the growth of parasite. However medications should be started as early as the infection starts and symptoms begin to appear.
The patient can prevent secondary infection by cleaning the infected legs daily by antiseptic lotions and soaps.
Surgery is done only for scrotal elephantiasis in which the scrotum gets abnormally enlarged. Surgical procedure is employed in case there is severe damage to the lymphatic nodes for removing them. However the surgery has to be repeated several times for clearing the thickened tissue and dead worms.