DEAR DR. GOTT: When my husband was stationed in the Philippines, he contracted filariasis, which was diagnosed after seeing dozens of doctors over 18 years. Can the disease affect his kidneys and other organs of his body? He knows it has already damaged his lymph nodes.
DEAR READER: It appears your husband was diagnosed with lymphatic filariasis, a parasitic infection from filarial worms that are threadlike in appearance and common in the tropics. Only the adult worms live in the human lymphatic system. There are three species of filarial parasites that inhabit the human lymphatic system. Each has distinct differences in appearance, and each calls for different treatment. All three can cause significant dermal damage, with the major symptom affecting the lymphatic system.
Filariasis is spread from person to person through mosquito bites. Tiny worms circulate through the person's bloodstream. When the mosquito bites, it ingests these worms and ultimately becomes infected. That insect can then pass the disease to other people. The adult worm has a life expectancy of up to seven years (rarely longer). During this time, the adult worms mate and release millions more microscopic worms into the blood. People with the worms in their bloodstream can pass the infection to others through mosquito bites.
According to the World Health Organization, about 120 million people are affected in tropical and subtropical areas of the world. They go on to say, â€œThe vast majority of infected people are asymptomatic, but virtually all of them have subclinical lymphatic damage, and as many as 40 percent have kidney damage.â€ So, to answer to your question, a person's kidneys can be damaged. Travelers should keep in mind that it takes repeated bites over months or even years to get lymphatic filariasis. Those briefly visiting the tropics are at very low risk.
A compromised lymphatic system can lead to lymphedema, which might be reversible in its initial stages; but acute stages can become irreversible, leading to chronic elephantiasis of the arms, legs, genitalia and breasts. Patients may have ulcers, abscesses, pleural effusions or pericarditis.
Annual treatment can be coordinated with DEC (diethylcarbamazine) and ivermectin, either drug alone or through the daily use of DEC-fortified salt. Treating chronic lymphedema and elephantiasis aggressively can reverse symptoms dramatically. Patients with heavily damaged extremities might benefit from surgical decompression of the lymphatic system.
If you finally found a physician that put the pieces of your husband's time in the Philippines and his symptoms together and came up with the correct diagnosis, I strongly urge you to follow his recommendations. That doctor sounds like a winner.
Readers may send a question to Peter Gott, c/o United Media, 200 Madison Ave., 4th Floor, New York, NY 10016. Gott is a retired physician and author of â€œDr. Gott's No Flour, No Sugar Diet.â€
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