Pathogenesis and treatment of chronic symptoms with emphasis on chyluria and elephantiasis.

versy as to on the role of bacterial infection Elephantiasis occurs in the chronic stage of lymphatic filariasis due to the obstruction of lymphatic vessels by fi-lariae. After invasion into lymph vessels, third stage larvae grow to maturity in the lymphatic system, mainly in and around the genitourinary system. Amaral et al. (1994) [1] observed actively moving adult worms in dilated and tortu-ous lymphatic vessels by ultrasonography. The subsequent blockage leads to lymphedema of the legs, arms, mammae, and other peripheral parts of the body. This situation causes hyperplasia of the connective tissues of the subcutis. The secondary and recurrent bacterial or fungal infections act to form the rough appearance of limbs and other parts of the body like elephant hide. Historically, elephantiasis, or elephantiasis arabicum,