Kallu a 30 year old man,, presented with subcutaneous itchy nodules over the left iliac crest. On examination they are firm, non tender and mobile. Skin scrapping contains microfilaria and adults worm of –
Correct Answer: Onchocerca volvulus
Description: Onchocerca volvulus Pathogenesis depends on the host's allergic and inflammatory reactions to the adult worm and microfilariae. The infective larvae deposited in the skin by the bite of the vector develop at the site to adult worms. Adult worms are seen singly, in pairs or in tangled masses in subcutaneous tissues. They may occur in the subcutaneous nodules or free in the tissues. The subcutaneous nodule or onchocercoma is a circumscribed, firm, non-tender tumour formed as a result of fibroblastic reaction around the worms. Nodules vary in size from a few mm to about 10 cm. They tend to occur over anatomical sites where the bones are superficial, such as the scalp,scapulae, ribs, elbows, iliac crest, sacrum and knees. The nodules are painless and cause no trouble except for their unsightly appearance. Microfilariae cause lesions in the skin and eyes. The skin lesion is a dermatitis with pruritus, pigmentation, atrophy and fibrosis. Ocular manifestations range from photophobia to gradual blurring of vision, progressing to total blindness. Ocular lesions include punctate or sclerosing keratitis, iridocyclitis, secondary glaucoma, choroidoretinitis and optic atrophy. REF:TEXTBOOK OF MEDICAL PARASITOLOGY;CKJ PANIKER;6TH EDITION;PAGE NO 209
Category:
Microbiology
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