Filarial elephantiasis In tropical regions, the bites of infected mosquitoes transmit a microscopic, thread-like, filarial worm.

These parasites enter the lymphatic vessels and are carried to regional lymph nodes (Cahill and Giles, 2001), where they cause a significant blockage resulting in lymphoedema. Because lymphatic filariasis is predominantly a disease of poor urban and rural populations, the lymphoedema is often untreated, and develops into irreversible elephantiasis (Fig 2). It is believed that 120 million people in over 80 countries are infected with lymphatic filarial worms (WHO, 2000). Treatments for chronic lymphoedema include: manual lymphatic drainage (MLD), which involves gentle, rhythmic massage to encourage the flow of lymph; complete decongestive therapy (CDT), which incorporates therapeutic exercise, short-stretch compression bandages, with skincare and MLD; and sequential gradient pump therapy, which helps to break up fibrotic tissue, re-enabling movement of lymph. Benzopyrones can promote proteolysis (breakdown of protein), permitting fluid to be reabsorbed (Ganong, 2001). The most spectacular symptom of lymphatic filariasis is elephantiasisedema with thickening of the skin and underlying tissueswhich was the first disease discovered to be transmitted by mosquito bites.[3] Elephantiasis results when the parasites lodge in the lymphatic system. Elephantiasis affects mainly the lower extremities, while the ears, mucus membranes, and amputation stumps are affected less frequently. However, different species of filarial worms tend to affect different parts of the body: Wuchereria bancrofti can affect the legs, arms, vulva, breasts, and scrotum (causing hydrocele formation)[3]; while Brugia timori rarely affects the genitals[citation needed]. Interestingly, those who develop the chronic stages of elephantiasis are usually amicrofilaraemic, and often have adverse immunological reactions to the microfilaria, as well as the adult worm.[citation needed] The subcutaneous worms present with skin rashes, urticarial papules, and arthritis, as well as hyperand hypopigmentation macules. Onchocerca volvulus manifests itself in the eyes, causing "river blindness" (onchocerciasis), the second leading cause of blindness in the world[citation needed]. Serous cavity filariasis presents with symptoms similar to subcutaneous filariasis, in addition to abdominal pain, because these worms are also deep tissue dwellers.

Lymph Nodes
Lymph nodes generally occur in groups along the larger lymphatic vessels. They are distributed throughout the body, but they lack the tissues of the central nervous system. All lymph nodes have the primary function of the production of lymphocytes, which help defend the body against microorganisms and against harmful foreign particles and debris from lymph before it is returned to the blood stream. The major locations are in six areas: (1) the cervical region: nodes in this area are grouped along the lower border of the jaw, in front of and behind the ears, and deep in the neck along the larger blood vessels. They drain the skin of the scalp, face, tissues of the nasal cavity, and the pharynx (2) the axillary region: these nodes are in the underarm region and receive lymph from vessels that drain the arm, the walls of the thorax, the breast, and the upper walls of the abdomen; (3) inguinal region: the nodes in this area receive lymph from the legs, the outer portion of the genitalia and the lower abdominal wall; (4) the pelvic cavity: the nodes here appear mostly along the paths of the blood vessels within the pelvic cavity and receive lymph from the lymphatic vessels in the area; (5) abdominal cavity: within this area, nodes occur in chains along the main branches of the arteries of the intestine and the abdominal aorta; (6) thoracic cavity: these nodes occur between the lungs and along

the windpipe and bronchi, and receive lymph from this area and from the internal wall of the thorax. The popliteal and inguinal nodes are in the legs and groin, the lumbar nodes in the pelvic region, the axillary nodes in the armpits, the cervical nodes in the chest. Hodgkin's disease is an enlargement of the lymph nodes in the neck, which gradually spreads throughout the lymphatic system, including the spleen. Pressure on adjoining organs and nerve endings can result in a dysfunction of vital organs or in paralysis.

Lymphatic Trunks
Lymphatic trunks drain lymph from the larger areas of the body, and they are named for the areas that they serve. The "lumbar trunk" drains lymph from the legs, lower abdominal wall, and the pelvic organs; the "intestinal trunk" drains organs of the abdominal cavity; the "intercostal" and "bronchomediastinal trunks" receive lymph from portions of the thorax; the "subclavian trunk" drains the arm; and the "jugular trunk" drains parts of the neck and head. These trunks then join one of two collecting ducts: the thoracic duct or the right lymphatic duct. After leaving these collecting ducts, lymph enters the veins to become part of the plasma, just before the blood returns to the right atrium of the heart.

lymphatic system
The lymphatic system and the cardiovascular system are closely related structures that are joined by a capillary system. The is important to the body's defense mechanisms. It filters out organisms that cause disease, produces certain white blood cells and generates antibodies. It is also important for the distribution of fluids and nutrients in the body, because it drains excess fluids and protein so that tissues do not swell up. "Lymph" is a milky body fluid that contains a type of white blood cells, called "lymphocytes," along with proteins and fats. Lymph seeps outside the blood vessels in spaces of body tissues and is stored in the "lymphatic" system to flow back into the bloodstream. Through the flow of blood in and out of arteries, and into the veins, and through the lymph nodes and into the lymph, the body is able to eliminate the products of cellular breakdown and bacterial invasion. Two very large areas are of significance in this system - the right lymphatic duct which drains lymph fluid from the upper right quarter of the body above the diaphragm and down the midline, and the thoracic duct, a structure roughly sixteen inches long located in the mediastinum of the pleural cavity which drains the rest of the body. It is through the actions of this system including the spleen, the thymus, lymph nodes and lymph ducts that our body is able to fight infection and to ward off invasion from foreign invaders. Lymph plays an important role in the immune system and in absorbing fats from the intestines. The lymphatic vessels are present wherever there are blood vessels and transport excess fluid to the end vessels without the assistance of any "pumping" action. There are more than 100 tiny, oval structures (called lymph nodes). These are mainly in the neck, groin and armpits, but are scattered all along the lymph vessels. They act as barriers to infection by filtering out and destroying toxins and germs. The largest body of lymphoid tissue in the human body is the spleen. Lymphatic filariasis is an infectious, parasitic disease caused by nematodes (roundworms). The disease is caused by the presence of thread-like worms, called filariae, in the lymphatic vessels and lymph nodes of the body. The lymphatic channels drain excess fluid from the body and play a role in the infection-fighting immune system. Lymphatic filariasis is transmitted by mosquitoes from person to person.

Infectious Disease Spotlight

Lymphatic Filariasis? Join the Discussion Lymphatic filariasis most commonly occurs in developing countries with a tropical climate. Wuchereria bancrofti, Brugia malayi, and Brugia timori are the specific worms that cause the infection. The larvae enter the body at the time of the mosquito bite and travel to the lymphatic system, where they mature into adult worms. The adult worms can live for years in the lymphatic system, and they produce immature forms that circulate in the blood. Lymphatic filariasis causes blockage of the lymphatic channels, leading to swelling and eventual scarring of the legs, known as elephantiasis, and in men, to swelling of the scrotum, or hydrocele. These symptoms are extremely disabling. These conditions are also disfiguring, and, in some communities around the world, people with the disease may be shunned. Globally, the disease affects more than 120 million people. The disease has been eradicated from the United States, with the last known case occurring in the 1920s. Lymphatic filariasis is found in the tropics of Asia, Africa, the Pacific, the Caribbean, and South America. Haiti, the Dominican Republic, Guyana, and Brazil are the affected countries in the Americas. Travelers to affected countries should be vigilant about mosquito protection (Source CDC). Seek prompt medical care if you notice swelling of your genitals or extremities, or if you have been in an affected area of the world and think that you may have been bitten by a mosquito. SYMPTOMS

What are the symptoms of lymphatic filariasis?

Typically, lymphatic filariasis does not have clinical symptoms, such as flu-like symptoms, fever, or vomiting. In fact, most people with lymphatic filariasis are unaware they have it. In a small percentage of infected people, lymphedema, or swelling, will occur, typically appearing years after the initial infection.... Read more about lymphatic filariasis symptoms o