 |
| Fig. 33.5 A, Caduceus. B, The classic
matchstick recovery technique used in extracting
the adult female worm. (From Zaiman
H, Jong EC: Parasitic diseases of the skin and
soft tissue. In Stevens DL, editor: Atlas of
infectious diseases, vol. II, New York, 1995,
Churchill Livingstone.) |
Dirofilaria tenuis, the raccoon heartworm, can cause
subcutaneous nodules.
Dracunculus medinensis, or guinea
worm, wanders through the subcutaneous tissue as part of its
life cycle and eventually settles down where it may cause
nodules and ulceration. Ivermectin, with or without
coadministration of albendazole, has been used in many of the
filarial diseases described previously. Dosages range from 200
to 400 mg/kg. The native treatment for
Dracunculus is to snare
the worm (up to 120 cm long in the female worm) through the
skin and roll it up on a stick (the matchstick technique). Some
medical historians believe that the caduceus (Fig. 33-5A), the
symbol for a physician, has its origins from the ancient method
of extracting the
Dracuncula worm with a stick (Fig. 33-5B).
