Infectious Disease Compendium

Brugia

Microbiology

A parasite. Brugia malayi and Brugia timori. They cause filariasis. (But not Dr. Phil-ariasis, a rapidly progressive dementia).

Epidemiologic Risks

Mosquito bites.

B. malayi: South and Southeast Asia.

B. timori: eastern Indonesian archipelago.

Syndromes

Lymphangitis or lymphadenitis with fever, headache, backache, and nausea; occasionally epididymitis, or orchitis may be seen. Later they get chronic lymphedema and elephantiasis.

Treatment

Diethylcarbamazine citrate po 6 mg/kg daily for 2 weeks reduces the number of microfilariae in the peripheral blood. Ivermectin in a single dose of 200 to 400 mg/kg. 6-weeks of doxycycline, either alone or in combination with diethylcarbamazine-albendazole, decreases microfilaremia and reduces adverse reactions to antifilarial treatment in B. malayi (PubMed). Expect relapse.

Doxycycline improves edema independenttly of effect on the parasite (PubMed).

Notes

Get a smear obtained at midnight for diagnosis, for that is when there are the most filaria in the blood, which coincidently is the time the mosquitos are most likely to feed. Evolution is so cool.

ICD9 Codes (Soon to be supplanted by ICD10)

Brugia malayi 125.1. Filariasis 125.9; Brugia (Wuchereria) (malayi) 125.1; bancrofti 125.0; brug's 125.1; loa loa 125.2; Malayan 125.1; malayi 125.1; malayi 125.1; organism NEC 125.6; Wuchereria (bancrofti) 125.0.