RT Book, Section A1 Langston, Shannon M. A1 Bales, Brian D. A2 Knoop, Kevin J. A2 Stack, Lawrence B. A2 Storrow, Alan B. A2 Thurman, R. Jason SR Print(0) ID 1181051306 T1 Elephantiasis T2 The Atlas of Emergency Medicine, 5e YR 2021 FD 2021 PB McGraw-Hill PP New York, NY SN 9781260134940 LK accessmedicine.mhmedical.com/content.aspx?aid=1181051306 RD 2024/03/29 AB Elephantiasis affects more than 120 million people worldwide with over 40 million severely disfigured. It is not a specific disease, but rather a syndrome caused by chronic obstruction of lymphatics. The most common cause is lymphatic filariasis, which is caused by the thread-like worms Wuchereria bancrofti, Brugia malayi, and Brugia timori. The infection is transmitted to humans by mosquitoes. Adult worms lodge in the lymphatics, disrupting the fluid balance between tissues and blood vessels, causing lymphedema of the extremities, breast, or genitourinary (GU) system. The infection is generally acquired in childhood, although clinical manifestations may take years to develop. Adult worms live 4 to 6 years, producing millions of blood circulating microfilariae. Acute symptoms of lymphadenopathy and dermal inflammation may precede and later accompany chronic swelling. With persistent infection and inflammation, the skin develops a hyperkeratotic, pebbly, or warty appearance that may become ulcerated and darkened. Bacterial and fungal superinfections contribute to morbidity.