Infectious Disease Compendium

Mansonella

Microbiology

A worm. M. ozzardi, M. perstans, M. streptocerca. They live in serous cavities of the human body. Look for the filaria on concentrated venous blood and there is an ELISA.

M. perstans and M. ozzardi are diagnosed by the finding of microfilariae in blood. There is no periodicity. M. streptocerca is diagnosed with microfilariae in skin biopsy.

Epidemiologic Risks

Mansonella ozzardi: blackfly and midge bite, in Latin America.

Mansonella perstans: midges in Africa and South America.

Mansonella streptocerca: midge bites in central Africa. Microfilariae can be found on skin biopsy.

Syndromes

Mansonella ozzardi: most asymptomatic.

Mansonella perstans: most asymptomatic. Swelling are similar to Calabar swellings due to L. loa nematodes. Calabar swellings are episodic angioedema of the arms and legs due to immune reactions. They are 3–10 cm, non erythematous, and non pitting. They can form cysts of connective tissue around muscle tendons that are painful with movement. They last for 1–3 days with localized urticaria and pruritus. Itching and abdominal pain most common symptoms.

Mansonella streptocerca: dermatitis.

Most have eosinophilia.

Treatment

Mansonella ozzardi: Ivermectin

Mansonella perstans: Best is mebendazole then doxycycline (PubMed). Here is something real cool: to live the Mansonella perstans requires the intracellular endosymbiont (like what got Spiderman and turned his spider suit black) Wolbachia. If you treat with doxycycline 200 mg a day for 6 weeks, you get rid of the Mansonella (PubMed).

Mansonella streptocerca: diethylcarbamazine.

Notes

Last update: 05/05/18