Dracunculiasis

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Background

Life cycle of Dracunculus medinensi.

Also known as Guinea Worm disease
Caused by Dracunculus medinensis - infection due to drinking contaminated water
Generally limited to central Africa
- Effort underway to eradicate disease in endemic countries^[1]

Helminth infections

Cestodes (Tapeworms)

Trematodes (Flukes)

Nematodes (Roundworms)

Ascaris lumbricoides
Enterobius vermicularis (Pinworm)
Filarial worms
Hookworm
- Necator americanus
- Ancylostoma duodenale
- Cutaneous larva migrans (Ancylostoma braziliense)
Dracunculiasis
Strongyloides stercoralis
Trichuris trichiura (Whipworm)
Anisakis
Toxocara spp.
Trichinosis

Clinical Features

Using a matchstick to wind up and remove a guinea worm from the leg of a human.

Adult worm migrates through subcutaneous tissues of the leg and erodes through skin, approximately 1 year after infection^[1]
Symptoms prior to eruption include: rash, intense pruritus, nausea/vomiting, dyspnea, and diarrhea

Differential Diagnosis

Travel-related skin conditions

Papules
- Insect bites
- Scabies
- Seabather's eruption
- Cercarial dermatitis (Swimmer's Itch)
Macular
- Chikungunya
Sub Q Swelling and Nodules
Ulcers
- Tropical pyoderma
- Leishmaniasis
- Mycobacterium marinum
- Buruli ulcer
- Dracunculiasis (Guinea Worm disease)
Linear and Migratory Lesions
- Cutaneous larvae migrans
- Photodermatitis

See also domestic U.S. ectoparasites

Evaluation

Clinical diagnosis

Management

Metronidazole 750mg TID x 5-10 days OR thiabendazole 50-75mg/day divided BID x 3 days
Must also extract adult worm from skin
Patients with active skin lesions should avoid contact with potable water

Disposition

Discharge

External Links

References

↑ ^1.0 ^1.1 Hopkins DR, Ruiz-Tiben E, Eberhard ML, Roy SL; Centers for Disease Control and Prevention (CDC). Progress toward global eradication of dracunculiasis--January 2013-June 2014. MMWR Morb Mortal Wkly Rep. 2014 Nov 21;63(46):1050-4.

Authors:

[Hopkins-1] 1.0 ^1.1 Hopkins DR, Ruiz-Tiben E, Eberhard ML, Roy SL; Centers for Disease Control and Prevention (CDC). Progress toward global eradication of dracunculiasis--January 2013-June 2014. MMWR Morb Mortal Wkly Rep. 2014 Nov 21;63(46):1050-4.

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