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Successful multi-modal treatment of grade IV lymphedema in lymphatic filariasis: A case study.

Authors
  • Sivaprakasam, R1
  • Anuradha, R2
  • Bethunaickan, R1
  • Manokaran, G3
  • 1 Department of Immunology, National Institute for Research in Tuberculosis, Chennai, India. , (India)
  • 2 International Centre for Excellence in Research, National Institute of Health, National Institute for Research in Tuberculosis, Chennai, India. , (India)
  • 3 Department of Plastic Surgery, Apollo Hospitals, Chennai, India. , (India)
Type
Published Article
Journal
Lymphology
Publication Date
Jan 01, 2018
Volume
51
Issue
2
Pages
89–92
Identifiers
PMID: 30253461
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

We present an integrated therapeutic approach performed on a 37 year old female with giant lymphedema (Grade IV) due to lymphatic filariasis of 27 years duration. Our therapeutic approaches consisted of a basic foot care program for two weeks, followed by a course of oral penicillin for a week including conservative treatment with complete decongestive therapy (CDT) together with respiratory physiotherapy and walking exercises. In addition, advanced surgical techniques with supra-fascial excision of alternate lumps in three stages over an interval of ten days followed by a nodo-venal shunt resulted in reversing the stage IV lymphedema condition. Over a ten year follow-up, the patient remains essentially unchanged confirming the success of the treatment without any recurrence or complications. Finally, by combining multimodal treatment, we were able to achieve a near normal limb in Stage III and Stage IV lymphedema of the lower limb in lymphatic filariasis. Copyright by International Society of Lymphology.

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