Male genital manifestations of infection with Wuchereria bancroftii
| Manifestations | Comments |
|---|---|
| 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 |