Administration of ivermectin or diethylcarbamazine to a patient with Loa loa can result in an encephalopathy that can be fatal.
Exposures:
(1) diethylcarbamazine
(2) ivermectin, with cases reported during mass administration for onchocerciasis
Proposed mechanism: micro-emboli in small brain vessels secondary to generalized paralysis of the microfilaria
Neurologic findings:
(1) encephalopathy with altered level of consciousness
(2) fatigue
(3) variable Parkinsonism
(4) mutism
(5) headache
(6) focal neurological signs
Other findings:
(1) hemorrhages in the palpebral conjunctiva and retina
(2) functional impairment
(3) generalized arthralgia
(4) incontinence
(5) fever
Risk factors:
(1) high level microfilaremia (> 8,000 per mL)
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Specialty: Infectious Diseases
