Migratory edema in the form of a wasp sting

Introduction Skin symptoms of Roa's filariasis: Adults migrate to subcutaneous connective tissue, causing allergic reactions due to the action of their metabolites, forming a rapidly developing carabar swell, a filarial mass (also known as a migratory mass). May be associated with systemic fever, local pain, and itchy skin. The diameter of the mass is 5~10cm, or it is a migratory edema of the wasp, which is harder than the general edema, and has elasticity. Sometimes it is red-like like erysipelas, which can occur in the primary site, and can also be extended to other parts. The mass lasts 2~ 3 days, more common in the forearm, between the fingers, the big fish muscles and thighs, gastrocnemius, waist, etc., groin, scrotum can also appear. Adults can crawl out of the body from the skin, and can also invade various organs, such as the stomach and bladder. Occasionally, those who invade the glottis or cause severe symptoms in the urethra.

Cause

When the human body sucks blood, the microfilaria can be inhaled and develop into infected larvae in the spotted larvae after about 7 days. When the sputum sucks again, the larvae in the infected period escape from the sputum to the human skin, and the blood is wounded by the blood. Invade the human body and mature in the human body for about 1 year. Adults migrate to subcutaneous connective tissue and develop disease.

1. Source of infection: The patient is the only source of infection. Although very apes can infect another night-type physiological strain of Roafil, it cannot infect the human body.

2, the route of transmission: the vector is the genus Veratris, mainly for the spotted cockroach and the spotted cockroach, commonly known as horsefly or red fly. It has been reported that African mosquitoes may also be an important vector.

3, susceptible population: people are generally susceptible to Roa. In the endemic areas, there are different degrees of acquired immunity due to repeated transmission of spotted bite residents.

an examination

Related inspection

Blood routine

Most patients have no other clinical symptoms except for elevated eosinophils in the blood. The main clinical manifestation is recurrent skin swelling, called "caraba", which is caused by the migration of adult worms to subcutaneous connective tissue. When a certain place is temporarily stopped, its metabolites stimulate local production without severe inflammatory reaction. The painful mass has a itching sensation, which is more common in the wrist and ankle. It is red in color, and the diameter is 2-3 cm. It gradually expands to 10-20 cm, lasting for several days to several weeks, and the worm body disappears. Adults can also invade other organs. When invading the anterior chamber of the eye, they often migrate from under the conjunctiva, causing severe conjunctivitis. Pericarditis, myocarditis, and endocarditis can be caused when the heart is invaded. In addition, it can cause encephalopathy, peripheral neuritis and joint degeneration.

Differential diagnosis

Cardiogenic edema: common in congestive heart failure, acute or chronic pericarditis. The characteristics of cardiogenic edema are:

1. The edema gradually forms, first manifested as a decrease in urine output, body weight, weight gain, and then gradually appear lower extremities and systemic edema.

2. Edema starts from the sagging part of the body and gradually develops into systemic edema. In general, the lower extremity can be depressed edema, which is most obvious.

3. Other symptoms and signs associated with right heart failure and elevated venous pressure, such as palpitations, asthma, jugular vein engorgement, hepatomegaly, and even chest and ascites. Related examinations include: electrocardiogram, X-ray examination, echocardiography, radionuclide and magnetic resonance imaging (MRI) examination, exercise tolerance and measurement of oxygen consumption in exercise peaks.

Malnutrition edema: also known as hypoproteinemia (hypoproteinemia) is a special manifestation of nutritional deficiencies. Due to the long-term negative nitrogen balance, plasma protein is reduced, colloid osmotic pressure is reduced, and systemic edema is characteristic. It is characterized by the often weight loss and weight loss before edema occurs. The tissue loss caused by the reduction of subcutaneous fat, the tissue pressure is reduced, and the edema of the edema fluid is aggravated. Edema often spreads throughout the body from the foot. The treatment of the cause of the disease and the adjustment of nutrition at the same time.

Idiopathic edema: This type of edema is an unexplained or undetermined cause (more than one reason) syndrome, more common in women, often associated with the periodicity of menstruation.

Nephrogenic edema: Edema is the most common clinical symptom and one of the common symptoms of kidney disease. Edema can be caused by many causes, and different edema has different characteristics. Edema caused by heart disease is called cardiogenic edema or cardiac edema; edema caused by liver disease is called hepatic edema or hepatic edema; similarly, edema caused by kidney disease is called nephrogenic edema. Nephrogenic edema is a kind of systemic edema. It is a common symptom of glomerular disease. It is caused by kidney disease, which causes water and sodium retention in the body, causing edema in different degrees of tissue loosening.

Sudden, painless local edema: Allergic edema is characterized by sudden, painless local edema. It belongs to the category of allergic diseases. Suddenly, painless, hard and elastic local edema, which is more common in the face, tongue, and lips, is a feature of angioedema.

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