Filariasis, commonly known as elephantiasis, is a parasitic disease caused by thread-like filarial worms—Wuchereria bancrofti, Brugia malayi, and Brugia timori. It predominantly affects tropical and subtropical regions, including India, and is transmitted to humans through the bite of infected mosquitoes. An estimated 120 million people are infected globally, with over 40 million experiencing severe disfigurement and disability.

• The life cycle of the filarial parasite involves two hosts: mosquitoes and humans. Infected mosquitoes deposit larvae on human skin, which then enter the body and migrate to the lymphatic system. Over several months, these larvae mature into adult worms that reside in the lymphatic vessels, causing blockages. This leads to lymphatic dysfunction and fluid accumulation, resulting in swelling (lymphedema) and thickening of the skin and tissues.

• Acute Phase Symptoms: Fever, chills, skin rashes, and lymphadenitis (inflammation of lymph nodes).
• Chronic Phase Symptoms: Lymphedema (swelling of limbs, breasts, or genitalia), hydrocele (swelling of the scrotum in men), and thickened skin with an “orange peel” texture.
• Physical Signs: Swollen limbs or scrotum, skin hardening, and severe lymphedema leading to elephantiasis.

• Investigations:
  • Blood Tests: Detecting microfilariae in the blood, usually at night.
  • Serological Tests: ELISA and immunochromatographic tests for filarial antigens.
  • Imaging: Ultrasound and X-ray lymphangiography to assess lymphatic damage.
• Medical Treatments:
  • Antifilarial Medications: Diethylcarbamazine (DEC), Ivermectin, and Albendazole to kill microfilariae and adult worms.
  • Symptom Management: Antihistamines, corticosteroids, and antibiotics for secondary infections.

• Traditional Surgical Options:
  • Hydrocelectomy: Removal of fluid around the testes in men with hydrocele.
  • Debulking Surgery: Removal of excess tissue in severe lymphedema cases.
• Microsurgery and Super Microsurgery:
  • Lymphaticovenular Anastomosis (LVA): Connecting lymphatic vessels to veins to improve drainage.
  • Vascularized Lymph Node Transfer (VLNT): Transplanting healthy lymph nodes to restore lymphatic function.
  • Pioneering Work: Dr. Ram Chilgar performed the first lymphatic microsurgery and VLNT in India at Elrevo Cosmetic and Plastic Surgery Clinic in 2014.
• Aftercare:
  • Hygiene and Skin Care: Preventing infections through regular cleaning.
  • Compression Therapy: Using garments to reduce swelling.
  • Physiotherapy: Exercises to promote lymphatic drainage.
  • Regular Monitoring: Ongoing check-ups to detect recurrences or complications.

These points provide a comprehensive overview of filariasis, covering its causes, life cycle, symptoms, diagnostic methods, treatment options, and the importance of advanced surgical techniques and aftercare in managing the disease.