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Either ivermectin, albendazole, or diethylcarbamazine is used to treat a filariasis infection by eliminating the larvae, impairing the adult worms' ability to reproduce, and by actually killing adult worms. Unfortunately, much of the tissue damage may not be reversible. The medication is started at low doses to prevent reactions caused by large numbers of dying parasites.
While effective, the medications can cause severe side effects in up to 70% of patients as a result either of the drug itself or the massive death of parasites in the blood. Diethylcarbamazine, for example, can cause severe allergic reactions and the formation of pus-filled sores (abscesses). These side effects can be controlled using antihistamines and anti-inflammatory drugs (corticosteroids). Rarely, treatment with diethylcarbamazine in someone with very high levels of parasite infection may lead to a fatal inflammation of the brain (encephalitis). In this case, the fever is followed by headache and confusion, then stupor and coma caused when massive numbers of larvae and parasites die. Other common drug reactions include dizziness, weakness, and nausea.
Symptoms caused by the death of the parasites include fever, headache, muscle pain, abdominal pain, nausea and vomiting, weakness, dizziness, lethargy, and asthma. Reactions usually begin within two days of starting treatment and may last between two and four days.
No treatment can reverse elephantiasis. Surgery may be used to remove surplus tissue and provide a way to drain the fluid around the damaged lymphatic vessels. Surgery may also be used to ease massive enlargement of the scrotum. Elephantiasis of the legs can also be helped by elevating the legs and providing support with elastic bandages.
— Carol A. Turkington
