Dracunculiasis

Also Know As Dracunculosis, Guinea Worm Disease, Fiery Serpent Infection

Dracunculiasis

            Dracunculiasis is an infectious disease brought about by Dracunculus medinensis or popularly known as the guinea worm that often causes painful skin blisters and other symptoms like fever and diarrhea. The infection is most commonly reported in far-flung areas of Africa especially among communities that do not have access to safe drinking water. ^{[1] [2]}

Epidemiology

            Starting 2006, merely sporadic cases have been noted in African countries. There is no racial or gender predilection observed. Most of the cases involve young adults but no specific age pattern is noted. ^[3]

Causes

            Dracunculus medinensis is the causative organism. Transmission takes place after individual drinks water contaminated with copepods.  Copepods serve as intermediary hosts to the infective parasite larvae. After copepods are digested, the larvae are released then wander to subcutaneous tissues and emerge from the skin. Soon blisters on the skin develop. ^{[1] [2]}

Signs and Symptoms

            Before blister develops, an affected person often experiences allergy symptoms like wheezing and itching. Some may also have fever. A skin blister is typically found usually at the lower extremity. Frequently, there are accompanying swelling, itching and burning pain. ^[3] Secondary bacterial infection may develop as some patients may have cellulitis, sepsis and septic arthritis. ^[2]

Diagnosis

            The patient’s history is important as it may give clues. Important to be noted are recent travel to endemic areas, drinking of untreated water and taking a bath or swimming in possibly contaminated water. Diagnosis is usually based on the history and characteristic skin lesion along with the identification of the worm’s head on the skin ulcer. ^[3]

Treatment

            The primary treatment entails adult worm extraction which could take a number of days to weeks depending on the length of the worm. The procedure involves pulling out the up-and-coming worm by rolling it around a stick until resistance is met. The process needs to be done gradually to avoid breakage which could leave behind segment of the worm. This is done repeatedly in combination with apposite wound cleaning and dressing until the entire worm is pulled out. Pain relievers like ibuprofen may be given. Topical antibiotics may be prescribed to avert secondary bacterial infections. Surgery may be indicated in some cases. ^[3]

References:

1.      http://www.medicinenet.com/guinea_worm_disease/article.htm

2.      http://www.orpha.net/consor/cgi-bin/OC_Exp.php?lng=en&Expert=231

3.      http://emedicine.medscape.com/article/997617-overview#a0199

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