Lymphangiectasia of lymphatics round the spermatic cords | Earliest sign of infection. Detectable by ultrasound in 80% of men found to have microfilaraemia. Initially asymptomatic |
Acute hydrocele | Develops when adult worms die naturally or as a result of therapy |
Chronic hydrocele | Detectable in up to 40% of males in areas hyperendemic for filariasis10 |
Chylocele | Collection of chyle that forms when a lymphatic ruptures into a hydrocele |
Lymph scrotum | Superficial scrotal lymphangiomatosis which may ooze chyle through deformed scrotal skin |
Acute inflammation of scrotum and penis | May be triggered by death of adult worms or superimposed bacterial infection. Tender scrotal nodules or irregularity of spermatic cords may be felt |
Elephantiasis of scrotum (fig 1) | Late hypertrophy and fibrosis that results from repeated bacterial infections. Urine flow not affected |
Inguinal adenitis | Develops acutely when adult worms die. Also triggered by bacterial infections in genitalia or legs. Occasionally filarial abscess develops |