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Africa
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Mainland South America: two months in British Guiana (Guyana) (July–August 1901)
Published in Gordon C Cook, Caribbean Diseases, 2018
Low clearly states in this letter that there was no evidence of trypanosomiasis (sleeping sickness) in British Guiana (see also Chapters 7 and 9). However, Mansonella perstans infection was prevalent. It is thus of considerable interest that both Manson and Low felt it worthwhile to investigate the ‘negro lethargy’ in Uganda with the underlying hypothesis that M perstans was the causative organism!4
Albendazole
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Infections with Mansonella perstans are generally asymptomatic, but are encountered in Africa and South America as a chance finding. Although data are limited, albendazole in a dose of 400 mg twice daily for 7 days appears to show efficacy against the adult worms but not against microfilariae (Sanguigni et al., 1990; Van den Enden et al., 1992; Lipani et al., 1997; Duong et al., 1998). A comparative study of albendazole, ivermectin, and the combination suggested that neither drug alone had any effect on microfilaria, but the combination produced a reduction (Asio et al., 2009a; Asio et al., 2009b). Thus, long-term follow-up, as with all filarial diseases, is needed to document an effect (Horton, 1998).
An unexpected peripheral blood finding: microfilaria
Published in Baylor University Medical Center Proceedings, 2020
John R. Krause, Meleissa Hutcheson, Rebecca Ardoin
The roundworm in our patient was Mansonella perstans, one of the three filarial species in the genus Mansonella (the other two being M. ozzardi and M. streptocerca), which are included in the category of serous cavity filariasis. In mammalian hosts, adult Mansonella worms are located in connective tissues or peritoneal, pleural, or pericardial cavities.4 Microfilaria of M. perstans will circulate in the blood and are approximately 190 to 200 μm in length × 4 μm (slightly smaller than the diameter of a red blood cell). The microfilariae are unsheathed; the tail tapers to a bluntly rounded end and nuclei extend to the end of the tail.5 Because the microfilariae are small, they can be overlooked in blood films. In the blood, they may be distinguished from other sympatric microfilariae including Loa loa or Wuchereria bancrofti, which are longer and sheathed and have larger terminal nuclei.5