_An infected deer fly , Chrysops spp, bites a healthy person.
_Infective L3 larvae are enter into the skin
_Larvae develop into adult worms in the subcutaneous tissue.
_Female worms produce microfilariae
_Microfilariae may migrate to the spinal cord, urine, sputum, lungs and peripheral blood vessels.
_In the deer fly microfilariae shed the sheath, migrate into midgut and then to thoracic muscles.
_ Microfilariae develop into L1 larvae then L3 larvae.
_L3 larvae migrate into deerfy proboscis and are innoculated into human host during the feeding of deer fly.
Rx: Tabs Diethylcarbamazine (DEC) 50 mg on day 1, 50mg TID on day 2, 100mg TID on day 3, then 2.7 to 3.3 mg/kg TID x 3/52.
NB: DEC worsens proteinuria and when there is intense infection encephalopathy may occur leading to coma and death.
Initial treatment with albendazole 200mg BD x 3/52 to reduce the microfilarial load to < 8000/ mL before DEC is initiated.