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Step 1
Observe the initial symptoms. An allergic reaction with mild breathing difficulties such as wheezing and itching irritated skin may be present. The patient also may have a fever.
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Step 2
Detect a blister in the skin, usually on the legs. It grows and becomes red as the female worm burrows to the surface of the skin. The site becomes inflamed with edema and more painful. The blister erupts in a few days and worm releases a larvae-containing fluid. The pain and swelling decreases markedly at this point and an ulcer forms as the adult worm emerges.
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Step 3
Diagnose dracunculiasis definitively when the worm is identified within the ulcer.
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Step 4
Take the patient's history. Travel to an endemic country is used to corroborate a diagnosis of dracunculiasis after the physical findings. A history of ingesting untreated water or eating fresh fruits or vegetables also may be involved.
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Step 5
Use plain-film roentgenography to identify calcified worms on the rare occasions when surgery is considered. Calcified lesions also have been discovered incidentally in response to complaints of pain in the legs.
