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Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/12704

Title: Theroleofultrasonographyinthedifferentiationofthevarioustypesoffilariceleduetobancroftianfilariasis
Authors: Mand, Sabine
Debrah, Alexander Y.
Klarmann, Ute
Mante, Sunny
Kwarteng, Alexander
et. al
Keywords: Filaricele
Hydrocele-staging
Hydrocele
Chylocele
Lymphaticfilariasis
Ultrasonography
Issue Date: 29-Jul-2010
Publisher: Elsevier B.V.
Citation: S.Mandetal./ActaTropica120S (2011) S23–S32. Theroleofultrasonographyinthedifferentiationofthevarioustypesoffilariceleduetobancroftianfilariasis. doi:10.1016/j.actatropica.2010.07.002
Abstract: Objective:(i)Todeterminethefrequenciesofurogenitalpathologiesinmeninfectedwithbancroftianfilariasis,and(ii)toevaluatetheroleofultrasonography(USG)asadiagnostictooltodifferentiatebetweendiversepathologieswithdifferentclinicalimplications.Todate,alltypesofscrotalenlargementresultingfromlymphaticfilariasis(LF)havebeensummarizedunderoneterm:“filaricele”.Patientsandmethods:DatawerecompiledfromrecruitmentphasesforfieldtrialsinanendemicareaforLFinGhana.1453menaged18yearsandaboveunderwentultrasoundexaminationsofthescrotum.Observationparameterswere:FilariaDanceSign(FDS),dilationofsupratesticularlymphaticvessels,thicknessofscrotalskin,occurrenceandamountoffluidaccumulation,echogenicityofthefluidbetweenthelayersofthetunicavaginalis,aswellaspositionandhomogenicityoftestis,epididymisandspermaticcord.In1132men,bloodsamplesweretakenforparasitologicalanalysis.Results:In56%ofexaminedpatients,fluidaccumulationaroundthetestiswasdetected(38%subclinical-,18%clinicalstages).Differentiationoftheechogenicityofthefluidrevealedecho-freehydrocele(EFH)in47%andecho-densehydrocele(EDH)in9%.Patientswithouthydroceleandsubclinicalstageshadathinnerscrotalskinthanthoseinclinicalstagesorwithlymphscrotum(P<0.001).IntheEDHgroupthescrotalskinwasthickerthanintheEFHgroup(P<0.001).1.4%hadalymphscrotum.FDSwasdetectedin24%ofall1453volunteerswhounderwentUSG.Thenumberofwormnestscorrelatedwithmicrofilarialloadandlevelsofcirculatingfilarialantigen(P<0.001;20%microfilaremic,48%antigenpositive).Conclusion:Inanunexpectedhighnumberofmen(56%)fluidaccumulationaroundthetestiswasdetectedbyUSGofwhichmorethanonethird(38%)presentedwithsubclinicalstages.Thestudyshowedthatecho-denseandecho-freefluidcouldbedifferentiatedandthataconsiderablenumberofcaseshadEDH(9%)posingarisktodevelopnecrotictestisandinfertilityandthereforerequiringimmediatesurgicalintervention.USGthusturnedouttobeausefuldiagnostictechniquetodifferentiatebetweenthosecasesrequiringimmediatesurgicalinterventionfromthosethatcanbetreatedwith(anti-wolbachialandhyperperme-abilityreducing)drugsthatameliorateorhaltprogressionofthedisease.
Description: An article published by lsevier B.V. and also available at doi:10.1016/j.actatropica.2010.07.002
URI: http://hdl.handle.net/123456789/12704
Appears in Collections:College of Science

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