A patient presents with subcutaneou nodules over Rt. iliac crest. Lymph node as well as skin smear shows microfilariae. Patient also has eye manifestatons .Most common filarial species involved –
First, I need to recall the different filarial parasites and their associated features. The main ones are Wuchereria bancrofti, Brugia malayi, and Onchocerca volvulus. Then there's Loa loa and Mansonella species, but I think those are less common in this context.
Wuchereria bancrofti is the most common cause of lymphatic filariasis, which typically presents with lymphadenopathy, elephantiasis, and hydrocele. Microfilariae are present in the blood, usually nocturnal. But wait, the question mentions subcutaneous nodules and eye involvement. Hmm.
Brugia malayi also causes lymphatic filariasis but is more common in Southeast Asia. The microfilariae are diurnal in the blood. But again, the eye involvement is a key point here.
Onchocerca volvulus causes onchocerciasis or river blindness. It's known for subcutaneous nodules called onchocercomas, and eye manifestations like chorioretinitis and sclerosing keratitis. The microfilariae are found in the skin and eyes, not in the blood. So this fits the subcutaneous nodules and eye issues mentioned in the question.
Loa loa causes loiasis with Calabar swellings and eye manifestations, but microfilariae are found in the blood and not in skin smears as much. Also, nodules aren't typical here.
So putting it all together: the presence of subcutaneous nodules and eye manifestations points to Onchocerca volvulus. The correct answer should be the one corresponding to that species. The options A-D aren't labeled, but in standard exams, these are common choices. The key is to match the clinical features with the parasite's characteristics.
**Core Concept**
The question tests identification of filarial species based on clinical presentation. **Onchocerca volvulus** is the primary cause of onchocerciasis, characterized by subcutaneous nodules (onchocercomas), microfilariae in skin/lymph nodes, and ocular lesions (e.g., chorioretinitis, sclerosing keratitis).
**Why the Correct Answer is Right**
**Onchocerca volvulus** is transmitted by blackflies and causes subcutaneous nodules (onchocercomas) due to adult worm encapsulation. Microfilariae migrate to skin and eyes, leading to **sclerosing keratitis** (a hallmark eye manifestation). Skin and lymph node smears reveal microfilariae, which lack sheaths and have a "tiger-tail" appearance, distinguishing them from other species.
**Why Each Wrong Option is Incorrect**
**Option A:** *Wuchereria bancrofti* causes lymphatic filariasis but lacks subcutaneous nodules and eye involvement. Microfilariae are blood-borne, not in skin smears.
**Option B:** *Brugia malayi* also causes lymphatic filari