Acanthocheilonemiasis: Description, Causes and Risk Factors:Acanthocheilonemiasis is a rare infectious disease caused by long "thread-like" worms, Acanthocheilonema perstans, also known as Dipetalonema perstans. The disease is transmitted by a small black insect (midge), called A. Cailicoides.Acanthocheilonema perstans, the parasite that causes acanthocheilonemiasis is common in central Africa and in some areas of South America. This disorder affects males and females in equal numbers.This disease is often transmitted when small flies bite the victim and the bite has the parasite with it. The scientific name of the fly that transmits the `infectious bite' is A. Coliroides. Studies manifest that the white blood cell levels at elevated when the parasite is present in the human body. Acanthocheilonemiasis belongs to the parasitic diseases group which is called nematode or filarial diseases. This disease is often found in Africa only because the parasite is found abundantly on this region. Uganda, specifically, has had a lot of reported cases. A handful of patients were found in South America.This disease is spread by the infested patients to healthy individuals to midges which take in microfilariae with their victim's blood. The larvae become infestive in about seven to ten days. They then travel to the insect's proboscis. The final stage is when they emerge and penetrate the human skin.This infectious disease is classified as a rare condition by the Office of Rare Diseases (affecting no more than 200,000 of the population in the United States).Prognosis of the patient's survival is favorable. Proper treatment will, more often than not, totally heal the patient of the illness.Symptoms:Initially people with acanthocheilonemiasis may have no symptoms. Symptoms occur more frequently in people who visit the areas where this parasite is common (endemic), than in people who are native to that area. One common laboratory finding, in people who have recently returned from infected areas, is abnormally high levels of specialized white blood cells (eosinophilia). Generally there are no symptoms associated with the laboratory finding.When symptoms appear they may include itchy skin (pruritus), abdominal pain, chest pain, muscle pains (myalgias), and/or areas of swelling under the skin (subcutaneous). Examination by a physician may reveal an abnormally enlarged liver and spleen (hepatosplenomegaly), and abnormally high levels of granular white blood cells (eosinophilia). The adult worm (nematode) may lodge in the tissues of the abdomen and chest causing inflammation and immune reactions. This may result in inflammation of the lining of the lungs (pleuritis) and/or the membranes that surround the heart (pericarditis).The early or pre-larval form (microfilariae) of acanthocheilonema perstans can be isolated from the blood from patients with acanthocheilonemiasis. Generally this disease is diagnosed by the examination under a microscope of a thick blood smear taken from the patient.Diagnosis:Examination of blood samples will allow identification of Acanthocheilonema perstans. It is important to time the blood collection with the known periodicity of the microfilariae. The blood sample can be a thick smear, stained with Giemsa or hematoxylin and eosin. For increased sensitivity, concentration techniques can be used.Examination of skin snips will identify microfilariae of Acanthocheilonema perstans. Skin snips can be obtained using a corneoscleral punch, or more simply a scalpel and needle. The sample must be allowed to incubate for 30 minutes to 2 hours in saline or culture medium, and then examined for microfilariae that would have migrated from the tissue to the liquid phase of the specimen.Treatment:Acanthocheilonemiasis is treated by means of the administration of antifilarial drugs, some of which are newer than others. Ivermectin or diethylcarbamazine (DEC) are frequently prescribed. Occasionally, surgery may be required to remove large adult worms. Mild cases of acanthocheilonemiasis do not require treatment.Doxycycline could be used to treat Acanthocheilonemiasis even if the patient does not show Lymphatic Filariasis. It has been proven that this drug greatly reduces the number of worms of Mansonella perstans that can be found in the patient's blood. 50% of the subjects that were first experimented on showed positive response. There are also alternative ways of treating the illness.NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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