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[Filarial meningoencephalitis: discussion of a case]
1Département d'Anesthésie-Réanimation, Centre Hospitalier Universitaire Yaoundé, Cameroun.
Abstract:
Loiasis treatment by diethylcarbamazine (DEC) may be complicated by a meningoencephalitis that is often fatal. Following one case, four others have been reviewed in the literature and the therapeutic approach in resuscitation departments discussed. Until the discovery of other less-dangerous microfilaricidal or macrofilaricidal drugs, we raise the question of the opportunity to treat loiasis by DEC, while many authors consider it as a simple nuisance.
Insights
Diethylcarbamazine (DEC) treatment for loiasis can cause fatal meningoencephalitis. This review questions the use of DEC for loiasis, a condition often deemed a minor nuisance.
Area of Science:
- Tropical medicine
- Parasitology
- Neurology
Background:
- Loiasis is a parasitic filarial disease prevalent in West and Central Africa.
- Diethylcarbamazine (DEC) is a standard microfilaricidal drug used for loiasis treatment.
- DEC administration can precipitate severe adverse reactions, including potentially fatal meningoencephalitis.
Observation:
- A case of DEC-induced meningoencephalitis in loiasis is presented.
- Four similar cases from the literature were reviewed.
- The therapeutic management of this complication in intensive care settings was discussed.
Findings:
- DEC-induced meningoencephalitis is a rare but severe complication of loiasis treatment.
- Prompt recognition and intensive supportive care are crucial for managing this condition.
- The risk-benefit profile of DEC for loiasis requires careful consideration, especially in endemic areas.
Implications:
- The findings challenge the routine use of DEC for loiasis, particularly when symptoms are mild.
- Further research into safer and equally effective alternative treatments for loiasis is warranted.
- Clinicians should be vigilant for signs of meningoencephalitis following DEC administration in patients with loiasis.