Scrotal filariasis

Scrotal filariasis is a manifestation of filariasis and refers to scrotal involvement from parasitic nematodes of the superfamily Filarioidea.

Known disease of the tropics and subtropics and a cause of morbidity in Asia, Africa and the Western Pacific regions 2.

Patients may be asymptomatic or present with fever or scrotal swelling. 

Filarial nematodes (sometimes shortened to filariae) are transmitted via mosquito bite to humans. The nematodes invade through the skin and into the lymphatics, where they form nests and multiply.

Lymphatic filariasis is transmitted by different types of mosquitoes:

  • Culex spp.: widespread in urban and semi-urban areas
  • Anopheles spp.: mainly in rural areas
  • Aedes spp.: mainly in endemic islands in the Pacific

Lymphatic filariasis is caused by infection with nematodes (roundworms) of the superfamily Filarioidea. There are three types of these thread-like filarial nematodes:

  • Wuchereria bancrofti: responsible for 90% of cases
  • Brugia malayi: causes most of the remainder of cases
  • Brugia timori: causes a minority of cases

Adult nematodes lodge in the lymphatic system and disrupt the immune system.

Dilated lymphatic channels (average diameter 6 mm) containing curvilinear echogenic undulating structures representing the microfilariae (usually 5-6) exhibiting the characteristic - but not pathognomonic - "filarial dance sign".

The parasites may affect the scrotum unilaterally or bilaterally and cause an associated hydrocele.

Treatment options include diethylcarbamazine (DEC) 6 mg/kg body weight in combination with albendazole.

Grossly dilated lymphatics and edema progressing to elephantiasis.

Ultrasound - general index
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Article information

rID: 26948
System: Urogenital
Synonyms or Alternate Spellings:
  • Filariasis involving the scrotum
  • Filariasis of the scrotum

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