Monday, January 23, 2017

Guinea worm disease (Dracunculiasis) - A Rare Case

A 36 years old male came to radiology department for X-ray chest with history of cough since one week. His X ray shows a rare finding in which the lung fields are clear, however, there are a string
like linear high density calcified guinea worms in the right axillary soft tissues. The X ray is shown below:


X-ray right knees (shown below) was done which shows calcified guinea worms in the soft tissues of the distal posterior aspect of thigh.


Case Discussion: Transmission of dracunculiasis has been eradicated all over the world except only a few African countries. Man acquires infection by drinking water containing infected cyclops. In the stomach these cyclops are digested by gastric juice and the parasites are released.
They penetrate the duodenal wall; migrate through viscera to the subcutaneous tissues of the various parts of the body. They grow into adults into 9–12 months. The female grows to a length of 55–120 cm, and the male is very short 2–3 cm. After infestation many of these parasites (usually gravid female, as male dies)
emerge out through the skin, while few of them are lodged in the subcutaneous tissues, die, get encapsulated and get calcified as string like appearance. Upon contact with water, the female parasite releases up to one million, microscopic larvae which remain active in water for 3–6
days. They are picked up by small crustaceans called cyclops. The larvae require a period of about 15 days for development in cyclops, which is the intermediate host.

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