Elephantiasis is a symptom or manifestation of a disease called Filariasis this disease is caused by a roundworm known as Wuchereria bancrofti. Humans get infected through the bite of female anopheles mosquito and Culex fatigans mosquito because any of these mosquitoes transmit the larvae of Wuchereria bancrofti into the skin whenever they bite.

What is Elephantiasis?

Elephantiasis is the most striking feature of filariasis and not the disease itself. Elephantiasis can also be caused by lymphogranuloma venereum which has3 etiologic types ofbacteria that causenon-filarial elephantiasis by causing the fibrosis of the lymphatic drainage system. Elephantiasis takes many years to develop, and is only seen in association with recurrent infection in endemic areas.

Elephantiasis of the legs

Differences between Filariasis and Elephantiasis

1. Filariasis is a disease caused by Filarial worm known as Wuchereria bancrofti
2. Elephantiasis is a feature of Filariasis
3. Elephantiasis can occur in another disease and is not only in filariasis.
4. Wucheriaria bancrofti is a nematode (roundworm) while lymphogranuloma venereum is bacteria these two organisms can cause Elephantiasis. While Wucheria bancrofti causes filarial elephantiasis, lymphogranuloma venereum causes non-filarial elephantiasis.

Elephantiasis Pathophysiology

Filarial roundworms cause elephantiasis by obstruction of the lymphatic drainage making the limbs and other parts of the body mostly affected to become enlarged as the foot of an elephant hence the name Elephantiasis or elephant foot disease as some people will call it. A single infection with filarial worms does not cause elephantiasis but repeated infections with fibrosis of the lymphatics causes blockage of the lymph drainage and thickening of the skin leading to elephantiasis.

Filariasis Transmission

Filariasis is transmitted by bite from female anopheles mosquito and culex mosquito that contains the infective larvae of Wuchereria bancrofti (filarial worms). It is not acontagious disease as it cannot be transmitted from man to man by direct contact.

Elephantiasis is caused by Wuchereria bancrofti

Filarial elephantiasis of the scrotum (scrotal elephantiasis)

Scrotal elephantiasis is caused by obstruction of the pelvic lymphatics by W. bancrofti with super-infection and lymphangitis. There is no medical treatment available for this condition and surgery may help by construction of new lymphatic pathways using plastic surgery.

Non-filarial elephantiasis (Other causes of Elephantiasis other than Filarial worms)

1. Non-filarial elephantiasis can result from fibrosis of the lymphatics caused by lymphogranuloma venereum (a chronic bacterial infection of the lymphatic system caused by 3 different types Chlamydia trachomatis bacteria).
2. Tuberculosis of the lymph nodes
3. Leishmaniasis
4. Recurrent episodes ofstreptococcal infections
5. Leprosy
6. Exposure to silica compounds
7. Idiopathic Elephantiasis – of which the cause is not known

Elephantiasis Treatment

When Filariasis has gotten to the stage of causing elephantiasis, there may be no cure for it because there is fibrosis of the lymphatic drainage system and thickening of the skin even surgical procedures have no benefit to the patient when the limbs are affected. Surgery may help reduce hydrocele and scrotal elephantiasis. The best way of treating filariasis is early detection and prompt treatment using ivermectin and albendazole (used with diethylcarbamazine) this prevents enlargement of body parts.

Elephantiasis Complications

1. Permanently swollen parts of the body that disfigures the person and causes cosmetics problems. The patient may become socially withdrawn.
2. Secondary streptococcal infection is common
3. Chyluria (milky like urine) and chylous ascites may occur
4. Tropical pulmonary eosinophilia which is a mild form of filariasis that affect the respiratory tract causing dry cough