Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a history of transient, localized subcutaneous angioedema (Calabar swellings) and/or migratory subconjunctival worm migration. Patient reports travel history to endemic regions in West or Central Africa. Symptoms include localized pruritus, erythema, and sensation of ocular foreign body.
Clinical Examination Findings
Physical examination reveals localized, non-pitting subcutaneous swellings, typically on extremities. Ocular examination may demonstrate visible subconjunctival migration of adult Loa loa nematode. Lymphadenopathy and hepatosplenomegaly are absent. Skin integrity is intact without secondary infection.
Treatment Protocol
Initiate treatment with Diethylcarbamazine (DEC) as the drug of choice, provided microfilarial load is low to avoid encephalopathy. If microfilarial load is high, consider initial treatment with Albendazole or apheresis to reduce parasite burden. Surgical extraction of the worm from the subconjunctival space is indicated if visible. Monitor for post-treatment inflammatory reactions.