Dracunculiasis

Dracunculiasis (Guinea worm infection): adult Dracunculus medinensis in deep connective/subcutaneous tissue, protruding externally. Main lesion: chronic skin ulcer.

Common Symptoms

Papule; muscle contracture; paraplegia; calcification; abscess

Causes and Pathogenesis

(1) Etiology: white smooth cylindrical female 60-120 cm × 0.9-2 mm, uterus filled with L1 larvae; male 12-40 × 0.4 mm. Larvae discharged into water (survive 7 days); ingested by Cyclops copepod → penetrate gut → hemocoel (12-14 d at 25°C, 2 molts, infective). Human drinks infected water → excyst in stomach → duodenum (13 h in dog: intestinal wall; 10-12 d: mesentery; 15 d: thoracoabdominal muscle; 21 d: subcutaneous; axilla/groin at 3.5 months). 3rd molt, mate; female fertilized at 3 months; male dies post-copulation. Mature female migrates to distal extremities (85% below knee) at 8-10 months; papule → blister → ulcer; on water contact, anterior end prolapses uterus discharging >500,000 larvae. (2) Pathogenesis: 85% lesions below knee; pruritic burning blister (cm-sized, yellow fluid with monocytes/eosinophils/PMNs/larvae); painful ulcer 1.25-1.8 cm with central punctum; female exits intermittently; secondary infection; allergic symptoms (urticaria/nausea/vomiting/diarrhea/wheeze) due to histamine-like toxins; adult may die subcutaneously → palpable cord → calcification.

Treatment

Drug therapy, supportive therapy

Preventive Measures

Filter/boil water; copepod control; diethylcarbamazine 5 mg/kg/day × 3 d monthly.

Department to Visit

It is recommended to visit the Gastroenterology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.