Q: Which one unique feature distinguish filarial lymphangitis from other causes of lymphangitis?

Answer:  Filarial lymphangitis occurs in a retrograde progression, means it spread away from the lymph nodes, where parasite resides. As parasites die they causes retrograde lymphangitis. Acute episode is followed by its complications as thickening of skin and subcutaneous tissue and superimposed bacterial infection. Organisms responsible  are wuchereria bancrofti, B. malayi, and B. timori.

It may be of interest for intensivists that adult worms can seen by bedside ultrasound of the inguinal, crural, and axillary lymph nodes and possibly adjacent vessels!


 References: 

1.  Pani SP, Yuvaraj J, Vanamail P, et al. Episodic adenolymphangitis and lymphoedema in patients with bancroftian filariasis. Trans R Soc Trop Med Hyg 1995; 89:72. 

2.  Dreyer G, Noroes J, Figueredo-Silva J. New insights into the natural history and pathology of bancroftian filariasis: implications for clinical management and filariasis control programmes. Trans R Soc Trop Med Hyg. 2000; 94(6): 594-6. 

3. Dreyer G, Noroes J, Figueredo-Silva J, Piessens WF. Pathogenesis of lymphatic disease in bancroftian filariasis: a clinical perspective. Parasitol Today. 2000; 16(12): 544-8. 

4.  Fox LM, Furness BW, Haser JK, Brissau JM, Louis-Charles J, Wilson SF, Addiss DG, Lammie PJ, Beach MJ. Ultrasonographic examination of Haitian children with lymphatic filariasis: a longitudinal assessment in the context of antifilarial drug treatment. Am J Trop Med Hyg. 2005; 72(5): 642-8.