Elephant

Elephant's disease overview

Foot disease i, also known as elephant leg edema, is a complication of lymphatic worm infection. The disease circulates mainly in hot and humid water and occurs caused by mosquitoes that transmit worm larvae to humans. Worms only parasitically in the lymphatic system, which is the damage of the lymphatic fluid causing fluids in the enlarged limbs, is called an elephant leg disease. Elephant foot treatment depends on the stages of the disease, mainly treatment that works well in the early stages. However, in this early stage, the disease is often overlooked due to the symptoms of the disease. With a special late stage, there are complications of the treatment results that are often limited, depending on the case of surgery.

Causes of Elephant's disease

The cause of elephant foot disease is due to worms. The world discovered three species of worms that only caused human disease, Wuchereria Bancrofti (W. Bancrofti), Brugia Malayi (B. Malayi) and Brugia Timori (B.Timori). In our country, only 2 species are detected, W. Bancrofti and B. Malayi (B.Malayi).

Features
  • W. Bancrofti species usually localize in the lymphatic or armpit lymphatic system. Worms W. Bancrofti mature looks like threads, opaque white from 25 - 40 mm long, about 0.1 mm wide. Worm W. Bancrofti is about 60 - 100 mm long.
  • Larvae B. Malayi has sex with genital lymph nodes and kidneys. In terms of worms, only B. Malayi is almost like worms W. Bancrofti. Male worms are about 22.8 x 0.08 mm, female worms about 55 x 0.16 mm.
    • male and female worms often roll together thus obstructing lymph vessels. The ability to exist in the environment:

    Worm larvae and mature worms do not exist in the natural environment, only exist in the human body and in the body of mosquitoes Disease.

    Symptoms of Elephant's disease

    Elephant foot disease is the most obvious manifestation in the complication of worm infection. Symptoms of elephant foot disease depend on each stage as follows:

  • The incubation stage: is the time from the time when the worm larvae are brought into the body until developing into adult worms.

    • Next is the stage of initiation: The symptoms of unknown symptoms depend on each case and easily confused with other diseases. Patients often appear fever, vasculitis in the armpits or groin areas with lymphadenopathy.

  • The last is the full phase: this period of lymphatic vascular system has been damaged leading to complications.

    • Manifestations of the full phase/complication period:

  • Appears with elephant legs. Patients will have continuous appearance, the skin gradually becomes thick, edema from the bottom to top. Most cases of edema on one side, most common is the feet evenly, can spread to the thighs. The patient's skin is increasingly thick and hard, on the skin may appear ulcers due to lack of nutrition.
  • Genital inflammation: Including inflammation, testicular inflammation, spill. Severe cases, genitals can be as big as elephant scrotum, elephant breast but not red and completely painless (should be called elephant edema). Genital inflammation has a serious impact on the quality of life of the patient.In addition, the patient seriously reduces the ability to work, daily life, physiological activities and greatly affecting the aesthetics. >
  • Urinary trees: White urine is like water, but for a long time without settling, sometimes there may be blood. In some cases, there is too much moisturizing in the urine, then the urine can last for a long time.

    • Transmission route of Elephant's diseaseElephant

    Elephant foot disease is not directly transmitted from the sick to a healthy person but must go through the intermediaries of mosquitoes. If the mosquito bites the patient and infected with the larvae and then burns others, it can be spread to others.

    People at risk for Elephant's disease

  • hot and humid climate, poor environmental sanitation, low -humid residence: is a favorable environment for the development of mosquitoes, so the areas with hot and humid climates are at risk of disease. higher.
  • Sleeping without curtains: enabling mosquitoes to transmit worm larvae pointing to the body.

    • Prevention of Elephant's disease

    Elephant foot disease is a disease that is transmitted by mosquitoes, so the disease prevention plays an important role in reducing the incidence of the disease: To prevent the disease, it is necessary to perform the following contents:

  • Surrounding surroundings often, clearing bushes, clearing sewers, throwing off the broken jar around the house.
  • Prevention of mosquito bites by sleeping mosquito nets, choosing bright clothes, in the evening wearing long pants, closed -sleeves to limit mosquito bites
  • Kill mosquitoes, eradicate infectious sources: Join the authorities in the launching campaigns to kill mosquitoes.

    • Diagnostic measures for Elephant's disease

    Elephant foot disease can be easily recognized at clinically when there is a large leg symptom, but for other cases, some tests can be performed for diagnosis. Early.

  • Blood test: There are worm larvae.
  • Consecrated testing test: Worm larvae can be detected.
  • Immune test with enameled Elisa enzyme.
  • Lymph nodes as anatomy.
  • Ultrasound, lymph vessels: Detecting lesions of the lymphatic system.

    • Elephant's disease treatments

    Elephant foot treatments include

    Complex decreasing treatment (Complex Decongestive Therapy-CDT)

    CDT is still considered an international standard for care for lymphatic treatment in general or elephant foot disease in particular, including two stages: attack and maintenance. 

    The goal of CDT is to increase lymphatic escape; to reduce swelling, discomfort, fibrosis and the risk of cellular inflammation; And to improve function and quality of life. The attack period includes a massage technique called manual lymphatic drainage (MLD), short bandages, exercises to create and enhance the inner pump mechanism, skin care and education in work Self -management. Skin care is necessary to prevent infections, control the penetration of bacteria and fungi, eliminate the overgrowth of bacteria in the gaps in the skin and moisturize the skin to avoid dryness and chapped skin. .

    The maintenance stage is often related to the use (s) of compressed clothes during the day, with patients at a worse stage that requires night compression by bandaging or replacing with compressed equipment and custom compressive equipment. MLD and exercise continue to play an important role in the treatment of lymphatic maintenance.

    Surgical method

    Although surgery is not a cure, sometimes these surgeries are considered when CDT and other methods cannot reduce symptoms. Surgical removal or removal and liposuction to help reduce excess tissue, and are often reserved for patients with the ability to move and the quality of life is seriously reduced by the disease. In addition, a number of newer microcental reconstructions, including lymphatic, transferred lymph nodes and lymphatic grafts, are being noticed.

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