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Filarial Worms Causing Subcutaneous Filariasis 109

punctate or sclerozing keratitis, iridocyclitis, secondary glaucoma, chorioretinitis
and optic atrophy.

Diagnosis
1. Microscopic examination
Detection of microfilariae from skin snip. The specimen is best collected
around midday.
2. Biopsy
In patients with ocular manifestations, microfilariae may be found in conjunc-
tival biopsies. Adult worms can be detected in the biopsy material of the subcu-
taneous nodule.
3. Molecular diagnosis
PCR of skin snips.

Treatment
Ivermectin (150 mg/kg once) is the main stay of treatment. DEC and suramin have
also been used. A 6-week course of doxycycline is given to target Wolbachia.
Surgical excision is recommended when nodules are located on the head due to the
proximity of the worm to the eyes.

Prevention and Control
1. Vector control (larvicides)
2. Insect repellents and protective clothings
3. Treatment of patients

Other Species That Can Cause Subcutaneous Filariasis

Mansonella streptocerca

Species That Can Cause Serous Cavity Filariasis

1. Mansonella ozzardi
2. Mansonella perstans

Species That Can Cause Zoonotic Filariasis

1. Brugia pahangi (filarial nematode of cats and dogs)
2. Dirofilaria immitis (dog heartworm)
3. Dirofilaria repens (filarial nematode of dogs and cats)