Dipetalonemiasis/Acanthocheilonemiasis is a rare tropical infectious disease caused by a parasite known as Acanthocheilonema perstans, which belongs to a group of parasitic diseases known as filarial diseases (nematode). This parasite is found, for the most part, in Africa. Symptoms of infection may include red, itchy skin (pruritis), abdominal and chest pain, muscular pain (myalgia), and areas of localized swelling (edema). In addition, the liver and spleen may become abnormally enlarged (hepatosplenomegaly). Laboratory testing may also reveal abnormally elevated levels of certain specialized white blood cells (eosinophilia). The parasite is transmitted through the bite of small flies (A. chlorides).
Causes
Acanthocheilonemiasis is a rare infectious disease caused by long “thread-like” worms, Acanthocheilonema Persians, also known as Dipetalonema perstans. The disease is transmitted by a small black insect (midge), called A. Culicoides.
Acanthocheilonema perstans, the parasite that causes Acanthocheilonemiasis is common in central Africa and some areas of South America. This disorder affects males and females in equal numbers.
Symptoms
Initially, people with Acanthocheilonemiasis may have no symptoms. Symptoms occur more frequently in people who visit the areas where this parasite is common (endemic) than in people who are native to that area. One common laboratory finding, in people who have recently returned from infected areas, is abnormally high levels of specialized white blood cells (eosinophilia). Generally, there are no symptoms associated with the laboratory finding.
When symptoms appear they may include itchy skin (pruritis), abdominal pain, chest pain, muscle pains (myalgias), and/or areas of swelling under the skin (subcutaneous). Examination by a physician may reveal an abnormally enlarged liver and spleen (hepatosplenomegaly), and abnormally high levels of granular white blood cells (eosinophilia). The adult worm (nematode) may lodge in the tissues of the abdomen and chest causing inflammation and immune reactions. This may result in inflammation of the lining of the lungs (pleuritis) and/or the membranes that surround the heart (pericarditis).
The early or larval form (microfilariae) of Acanthocheilonema Persians can be isolated from the blood of patients with Acanthocheilonemiasis. Generally, this disease is diagnosed by the examination under a microscope of a thick blood smear taken from the patient.
Treatment
Acanthocheilonemiasis is treated using the administration of antifilarial drugs, some of which are newer than others. Ivermectin or diethylcarbamazine (DEC) are frequently prescribed. Occasionally, surgery may be required to remove large adult worms. Mild cases of acanthocheilonemiasis do not require treatment.
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