Dracunculus medinensis

1. Adult Female

1.1. It has a long slenderical body, filled with uteri. 90-100 cm x 2 mm. Female D. medinensis is larviparous

2. Morphology

2.1. Rhabditiform larva

2.1.1. Comma shaped. 500-750 x 20 µm. It never detected in the blood or in human tissues

2.2. Adult Male

2.2.1. It is shorter than its female. 2 cm x o.4 mm.

3. TRANSMISSION

3.1. drinking water contaminated with infected copepods (Cyclops).

4. HABITAT

4.1. Adult female D. medinensis inhabits the subcutaneous tissues particularly that of the lower limb, while its rhabditiform larva infest Cyclops.

5. LIFE CYCLE

5.1. Infective stage: rhabditiform larvae after 21 days in the Cyclops.

5.2. Diagnostic stage: rhabditiform larvae or the worm in its position.

5.3. Intermediate host(s): Cyclops.

5.4. Final host: man.

5.5. Reservoir host: infected host.

6. CLINICAL PICTURE

6.1. Onset of fever, urticaria, itching, allergic manifestations e.g. asthma or periorbital edema in the allergic patients. There is a relief of symptoms after the blister is ruptured. Worms is detected under the skin with serpentine pattern

7. IMMUNE RESPONSE

7.1. The main immune reaction against medina worm infection is a Localized cellular immune reaction to limit the infection, together with increased IgE level in the serum.

8. DIAGNOSTIC PROCEDURES

8.1. Diagnosis is typically based on clinical manifestations. In endemic areas the characteristic worm’ containing lesion is easily recognizable

8.2. The worm can be stimulated to discharge larvae by submerging the ulcer with water.

8.3. Plain x-ray may demonstrate the calcified dead worms in the subcutaneous tissues.

9. TREATMENT

9.1. Niridazole (Amblihar)

9.2. Metronidazole

9.3. Thiabendazole