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Step 1
Treat cases of asymptomatic filariasis on an outpatient basis. Diethylcarbamazine (DEC) is given orally and should be supervised to ensure compliance with the therapy. This allows any febrile reactions to be managed in heavily infected patients.
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Step 2
Require initial inpatient care for some cases of lymphatic filariasis and chronic filariasis. Onchocerciasis being treated with DEC and suramin also may require inpatient care to monitor complications and reactions from this therapy.
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Step 3
Provide primary treatment for filariasis with DEC and manage secondary infections with antihistamines, intravenous antibiotics, steroids and pain relief. Chronic lymphedema is traditionally managed with compression bandages, bed rest and limb elevation. Reduce the swelling of lymphedema with steroids.
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Step 4
Restrict the fat intake in patients with chyluria known to result from lymphatic filariasis.
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Step 5
Perform surgical excision on scrotal elephantiasis and large hydroceles caused by lymphatic filariasis. Limb elephantiasis is more difficult to treat with surgery and may require multiple procedures with skin grafting. Perform a nodulectomy with local anesthetic to treat skin and eye complications from cutaneous filariasis.
