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Mansonella perstans infection
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Mansonella perstans infection

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Contributors: Vivian Wong MD, PhD, Susan Burgin MD
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Synopsis

Mansonella perstans (also known as Dipetalonema perstans or Acanthocheilonema perstans) causes 1 of 3 forms of human mansonelliasis, along with Mansonella ozzardi and Mansonella streptocerca. Mansonella perstans is transmitted by Culicoides biting midges in Africa and South America.

Mansonella perstans infection occurs when a female midge takes a blood meal from a human, which allows the transfer of filarial larvae to the bite wound. The filarial larvae develop into adults in deep connective tissue and serous cavities, where they produce microfilariae. When a midge takes a blood meal from an infected host, the microfilariae are ingested and develop into larvae in the midge's gastrointestinal tract.
 
Mansonella perstans is highly prevalent in endemic regions in Africa and South America. Though often considered nonpathogenic with subclinical infections, M. perstans can cause various symptoms including fever, arthralgia, fatigue, headache, conjunctival nodules, and abdominal pain. Cutaneous symptoms include pruritus, subcutaneous nodules, and angioedema. In severe cases, M. perstans can cause serositis, with pericarditis, hepatitis, or encephalitis.

Co-infection with other filarial diseases, especially Wuchereria bancrofti, is common. Treatment of M. perstans infection is difficult as most antifilarial agents have limited efficacy. It has been recently discovered that certain strains of M. perstans harbor the intracellular bacterial endosymbiont Wolbachia. These strains are effectively eradicated using anti-wolbachial therapy with doxycycline.

Codes

ICD10CM:
B74.4 – Mansonelliasis

SNOMEDCT:
420811004 – Infection caused by Mansonella perstans

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Differential Diagnosis & Pitfalls

Other filarial diseases:
  • Streptocerciasis (Mansonella streptocerca infection) – Causes shoulder or chest dermatitis and hypopigmentation in an adult patient. The disease is endemic to Central and West Africa.
  • Mansonella ozzardi infection – Causes pruritus, angioedema, and hyperpigmentation but not serositis. The disease is endemic to the Caribbean and South America. Similar to M. perstans, there is peripheral eosinophilia, and microfilariae are detected on peripheral blood smear. On microscopic examination, the microfilariae differ from those of M. perstans as they are sheathed and have pointed tails with small nuclei.
  • Onchocerciasis (Onchocerca volvulus) – Causes cutaneous disease and river blindness. Cutaneous symptoms include papular dermatitis, pruritus, lichenification, atrophy, and a "leopard-skin" depigmentation. The disease is endemic to Africa, Latin America, and the Middle East.
  • Loiasis (Loa loa) – Causes subcutaneous and ocular filariasis. Cutaneous symptoms include localized swellings, angioedema, and pruritus. The disease is endemic to Central and West Africa.
Other dermatoses:

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Last Updated: 10/24/2016
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Mansonella perstans infection
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Mansonella perstans infection : Fatigue, Fever, Headache, Conjunctival nodule, Eosinophilia, Face, IgE elevated, Arthralgia, Pruritus, Wheal, Hands, Forearms
Copyright © 2019 VisualDx®. All rights reserved.