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Filarial Lymphoedema Management — SCE Infectious Diseases MCQ

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EasyTropical & Imported InfectionsFilarial Lymphoedema ManagementSCE Infectious Diseases

A 40-year-old man from rural Kenya presents with chronic progressive lymphoedema of his right leg and recurrent episodes of bacterial cellulitis (ADLA). He has a history of filarial infection treated years ago. The lymphoedema is now irreversible. What is the cornerstone of long-term management?

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Correct answer: D — Hygiene-based lymphoedema management: daily washing with soap and water, elevation, exercise, skin care (emollients), prompt treatment of bacterial superinfection (ADLA), and compression where available

Chronic filarial lymphoedema is irreversible — the lymphatic damage is permanent. Management focuses on preventing progression and reducing acute ADLA episodes: (1) daily washing with soap and water, (2) careful drying and moisturising skin (emollients), (3) elevation, (4) exercise, (5) nail care and footwear to prevent skin breaks, (6) prompt antibiotic treatment of ADLA episodes (Amoxicillin or Penicillin V). This WHO-recommended hygiene-based approach reduces ADLA frequency by >50% and prevents lymphoedema progression. Antifilarial drugs do NOT reverse established lymphoedema.

Reference: WHO 2022 – Lymphatic filariasis morbidity management; UKHSA 2023