A patient with Wuchereria bancrofti may develop a number of systemic symptoms following therapy with ivermectin, albendazole or other antifilarial agent. The onset of symptoms is usually within a few days of starting therapy.
Common reactions (Figure 2, page 333):
(1) headache
(2) fever
(3) vomiting
(4) fatigue and lethargy
Additional reactions:
(5) myalgias
(6) dyspnea
(7) diarrhea
(8) rash
(9) anorexia
(10) hypotension
(11) weakness
The severity of the post-treatment reaction tends to correlate with the microfilarial count.
A scorecard can be used to monitor the severity based of the following symptoms (page 332):
(1) rash
(2) fatigue and lethargy
(3) diarrhea
(4) anorexia and change in appetite
(5) vomiting
(6) scrotal pain
(7) headache
(8) myalgias
(9) cough
(10) dyspnea
(11) fever
(12) hypotension
Severity of Reaction
Points
none
0
mild
1
moderate
2
severe
3
life-threatening or disabling
4
total score =
= SUM(points for all 12 items)
Interpretation:
• minimum score: 0
• maximum score: 48
• The higher the score the more severe the reaction.
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