Role of streptococcal infection in the acute pathology of lymphatic filariasis

Growing evidence suggest that secondary bacteriol, mainly streptococcal, infections contribute significantly to recurrent episodes of acute adenolymphangitis (ADL) of filarial origin. We examined the role of group A streptococci in the progression of lymphedema in Polynesian patients with filariasis-related ADL (22 cases) or chronic pathology (10 cases), or with erysipela (10 patients) and, as controls, in 20 healthy adults. Antistreptolysin O (ASLO) and anti-streptodornase B (ASDB) titers were systematically determined in parallel to parasitological and biochemical tests. ASLO and ASDB assays were positive in 100 % of erysipela, 75 % of filarial ADL as compared ro 50 % of chronic pathology and 39 % of healthy controls. interestingly, by opposition to ASLO liters which were not significantly different between the four groups, ASDB titers were higher in ADL (p = 0.0101 and erysipela (p = 0.002) than in controls. These results support the hypothesis that recurrent streptococcal infections may have an important role in the pathogenesis of ADL in lymphatic filariasis.