Abstract
Loa loa is a filarial parasite that is endemic in Central and West Africa. Transmitted by tabanid flies of the genus Chrysops, adult worms migrate through subcutaneous tissues and release microfilariae into the bloodstream, where they circulate with diurnal periodicity. Symptoms include transient migratory angioedema (Calabar swellings) and subconjunctival migration of adult worms (eyeworm). Definitive diagnosis is made by identification of parasites in the blood or tissues. Presumptive diagnosis relies on a combination of clinical symptoms or unexplained eosinophilia in the setting of positive serologic testing. Loiasis is curable with diethylcarbamazine (DEC) treatment, although multiple courses may be necessary, and serious complications of therapy can occur in patients with high levels of circulating microfilariae. Weekly prophylaxis with DEC is effective in preventing infection in travelers to endemic areas.
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